Tot and Tvt Surgery
TOT and TVT surgery are among the surgical methods used for stress urinary incontinence, especially when coughing, sneezing, laughing, climbing stairs or exercising. The aim of these surgeries is to help reduce urine leakage in case of sudden increases in intra-abdominal pressure by providing support to the middle section of the urinary tract.
Not every type of urinary incontinence develops for the same reason. For this reason, for patients considering TOT and TVT surgery in Istanbul, the decision is not only based on the presence of the complaint; Examination findings, type of urinary incontinence, pelvic floor support, previous surgeries, accompanying prolapse findings and the person's expectations should be evaluated together. Assoc. Dr. Nazlı Korkmaz determines the most appropriate treatment plan for the patient individually during the urogynecological evaluation.
What is TOT and TVT Surgery?
TOT and TVT are mid-urethra sling surgeries used in the treatment of stress urinary incontinence. In both methods, a thin sling material is placed in the middle part of the urinary tract to provide support. This support helps the urinary tract to close in a more controlled manner in case of sudden movements or increased pressure.
Article Summary
TOT and TVT surgery are mid-urethra suspension methods used in the treatment of stress urinary incontinence. Which method is appropriate is determined by evaluating the patient's examination findings, type of urinary incontinence and accompanying pelvic floor problems.
What Will You Find in This Article?
- What are TOT and TVT? The basic logic of mid-urethra sling surgeries is explained.
- Who is it suitable for? Stress urinary incontinence and patient selection are discussed.
- How is the surgery process? The points to be considered during the preparation, procedure and recovery period are summarized.
- What are the risks and the decision process? It is explained why the surgical decision should be made individually.
TOT method is a technique in which the sling is placed with a transition line extending towards the groin area. In the TVT method, the sling is positioned along a different anatomical line. Although both methods are used for the same purpose, they may differ in terms of route of passage, patient selection and surgical planning.
What is Stress Urinary Incontinence?
Stress urinary incontinence is a form of urinary incontinence associated with increased intra-abdominal pressure rather than bladder contraction. It is typical to leak urine during coughing, sneezing, laughing, heavy lifting, running or exercise. This situation can affect the quality of daily life, social life and the person's self-confidence.
To get more general information about stress urinary incontinence, you can review our article Treatment of Stress Urinary Incontinence.
Who is TOT and TVT Surgery Suitable for?
TOT or TVT surgery is usually considered in patients with significant stress urinary incontinence and who do not receive sufficient benefit from conservative methods. However, before the decision for surgery is made, the type of urinary incontinence should be clarified. Because the treatment approach may be different in cases of urge urinary incontinence, overactive bladder or mixed urinary incontinence.
- Urinary incontinence during coughing, sneezing or exercise,
- Stress type incontinence causing daily pad use,
- The complaint persists despite pelvic floor exercises and lifestyle adjustments,
- Detection of weakness of urethra support during examination,
- The patient makes a decision by understanding the surgical process and possible risks.
“ The main goal in TOT and TVT surgery is not only to reduce urinary incontinence, but also to help increase the comfort of daily life in the right patient with the right surgical plan.”
How is Preoperative Evaluation Done?
During the preoperative evaluation, a detailed history is taken. When urinary incontinence occurs, how long it lasts, whether it is accompanied by a feeling of urgency, urination at night, history of infection, number of births and previous gynecological surgeries are questioned.
During the examination, pelvic floor support, uterine or bladder prolapse, vaginal tissue condition and urethra mobility are evaluated. Additional examinations such as urinalysis, bladder diary, ultrasonography or urodynamics may be requested in necessary patients. For general treatment options for urinary incontinence, you can also take a look at our Urinary Incontinence Treatment page.
How is TOT Surgery Performed?
In TOT surgery, the middle part of the urinary tract is reached through a small vaginal incision. The sling material is placed in a way that supports the urinary canal and is positioned in a line extending towards the groin area. The procedure is usually a short surgical procedure; However, surgery duration may vary depending on the patient's anatomy and accompanying procedures.
The purpose of the TOT method is not to completely compress the urinary tract, but to provide controlled support during movement and pressure increase. Therefore, the tension and placement of the sling are among the important points of surgery.
How is TVT Surgery Performed?
In TVT surgery, a sling material that provides support is placed in the mid-urethra region. Its difference from the TOT method is that the anatomical passageway of the sling is different. Which method to choose; It is determined according to the patient's examination findings, previous surgeries, accompanying sagging condition and the surgeon's clinical evaluation.
While the TVT method may be more appropriate for some patients, TOT or different treatment options may be more appropriate for some patients. For this reason, the "one method for every patient" approach is not correct.
What are the Differences Between TOT and TVT?
| Criteria | TOT | TVT |
|---|---|---|
| Main purpose | Providing support to the mid-urethra | Providing support to the mid-urethra |
| Passage path | The path extending towards the groin line is used | Different anatomical transition line is used |
| Patient selection | Determined according to inspection and risk assessment | Determined according to inspection and risk assessment |
| Decision process | Personalized planning required | Personalized planning required |
Recovery Process After TOT and TVT Surgery
In the postoperative period, mild pain, tenderness in the groin, vaginal spotting or temporary burning during urination may occur. Although the return to daily life is short in most patients, the period recommended by the physician should be followed for activities such as heavy lifting, intense exercise and sexual intercourse.
- It is important to drink plenty of fluids and not delay urination in the first days.
- Heavy exercise should not be started without a doctor's recommendation.
- In case of vaginal bleeding, fever, foul-smelling discharge or inability to urinate, a doctor should be consulted.
- Control examinations should not be interrupted.
Possible Risks and Things to Consider
As with every surgical procedure, there may be some risks in TOT and TVT surgeries. Situations such as bleeding, infection, difficulty urinating, incomplete emptying of the bladder, pain, tissue problems due to the sling material, or persistence of the complaint may rarely occur. These risks may vary depending on the patient's general health condition, the structure of the tissues, previous surgeries and the method applied.
For this reason, expectations should be discussed realistically before surgery and alternative treatment options should be evaluated. For a more comprehensive evaluation of urogynecological problems, you can review our Urogynecology page.
TOT and TVT Surgery in Istanbul
The most important point when planning TOT and TVT surgery in Istanbul is to determine whether the patient's complaint is truly compatible with stress urinary incontinence. Even in two patients describing the same complaint, the treatment plan may be different. While pelvic floor exercises, lifestyle adjustments or drug treatments may be a priority in some patients, surgical options may be considered in some patients.
Assoc. Dr. As a gynecologist and obstetrician in Istanbul, Nazlı Korkmaz offers a personalized approach to her patients in urogynecological evaluation, urinary incontinence treatment and surgical planning processes.
TOT and TVT Surgery Prices 2026
TOT and TVT surgery prices; It may vary depending on the method to be applied, hospital conditions, type of anesthesia, whether additional procedures are required, accompanying prolapse treatment and the clinical condition of the patient. Therefore, net price information can be given after inspection and evaluation.
To get information about current TOT and TVT surgery prices for 2026, the best approach is to make personalized planning after the examination.
Frequently Asked Questions
These surgeries are most common in cases of stress urinary incontinence. The treatment approach may be different for complaints of urge urinary incontinence or overactive bladder.
Both methods are mid-urethral sling surgery and are applied for similar purposes. However, the passageway of the sling material and surgical technical details are different.
Proper method; It is determined by evaluating the examination, type of urinary incontinence, pelvic floor support, accompanying prolapse findings, previous surgeries and personal risks.
The surgery is performed under anesthesia. There may be mild pain, groin tenderness, or vaginal discomfort afterward; This process can usually be controlled with medications recommended by the doctor.
The time it takes to return to daily life varies from person to person. Light daily activities can begin shortly; The period recommended by the physician should be waited for heavy lifting, sports and sexual intercourse.
Some patients may have temporary difficulty urinating. Persistent or significant strain is rare, but in such a case a physician evaluation is required.
The aim is to reduce complaints and improve quality of life; However, definitive results cannot be guaranteed in any surgery. Success is related to correct patient selection and personal factors.
No. However, in surgeries using sling material, problems such as tissue sensitivity, pain, infection or erosion may rarely occur. These risks should be discussed clearly before surgery.
This decision should be made individually. Age, pregnancy plan, severity of the complaint, examination findings and alternative treatments are evaluated together.
Assoc. Prof. for TOT and TVT surgery evaluation in Istanbul. Dr. You can get information about examination and treatment planning by contacting Nazlı Korkmaz clinic.
The Importance of Personalized Evaluation in TOT and TVT Surgery
TOT and TVT surgery are among the important surgical options in the treatment of stress urinary incontinence when the right patient selection is made. However, for a successful treatment plan, the type of urinary incontinence, pelvic floor structure, accompanying sagging findings, patient expectations and lifestyle should be evaluated together.
Assoc. Dr. You can request an appointment with Nazlı Korkmaz to get information about TOT and TVT surgery, urinary incontinence treatment and urogynecological evaluation in Istanbul.