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Which patients are best suited for a TVT versus a TOT sling when managing stress urinary incontinence?
Dr. Amr Nabil Badawy
Board-CertifiedScientific Director
PhD, MRCOG, MSc
1. TVT (Retropubic Tape)
Route: Passes behind the pubic bone.
Best for:
- Intrinsic sphincter deficiency (ISD)
- Previous anti-incontinence surgery failures
- Obese patients (better long-term outcomes)
Caution: Higher risk of bladder perforation.
2. TOT (Transobturator Tape)
Route: Passes through obturator foramen (groin).
Best for:
- Mild-to-moderate SUI without ISD
- Patients with higher risk of bladder injury
- History of prior retropubic surgery
Pros: Almost no risk of bladder perforation and faster recovery.
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