TOT surgery for stress urinary incontinence (SUI)

Brenda, 66 years old, from Rainham in Essex had been living with a successful trans obturator tape (TOT) after her hysterectomy when she began to experience problems.

Brenda said: “I felt perfect for five years then one day I started to leak. I had a hysterectomy five years previously and at the time of the operation had a TOT fitted so that I would not suffer from stress urinary incontinence (SUI). It worked until years later (when) I started to leak.”

Brenda began to leak on a daily basis and it started to affect her everyday life. Brenda explains: “I would stand up and leak. I could be shopping and leak or just walking down the road. I started to wear pads everyday and even began to wear dark clothing so that leaks would not show. On holiday I had to make sure I packed enough pads. It was on my mind every day. Dancing was out of the question and I was concerned about odour. It stared to reduce my quality of life.”

Brenda spoke to her sisters about her issue and her husband was also supportive and encouraged her to get some help. “I am lucky that I had other women to talk to and a husband I can be open with, but I know that some women just can’t talk about intimate things like this with their partner. I went to my GP after seeing Mr Gujral at a seminar and asked to be referred to him and used my private medical insurance to pay for treatment.”

Brenda was sent for urodynamic tests to determine the type of incontinence that she had. She continues: “The urodynamic tests are embarrassing and uncomfortable but not painful. It was the worst bit but the people who do the tests have seen it all before and put you at ease. I would do it all again if I had to, nothing is worth living with incontinence.”

After her tests Brenda booked to see Mr Gujral and decided to go ahead with the operation to replace her TOT. Brenda explains: “Mr Gujral told me that it was rare that a TOT would need to be replaced. I was just unlucky but once I had seen him I was confident he could sort it out and everything moved quickly from there.”

In August 2010 Brenda had her TOT replaced by Mr Gujral at Spire Hartswood private hospital in Brentwood, Essex and it was a success. “I was shown to my own room with an en-suite. It was clean and comfortable and the staff put me at ease. It was a good environment to be in as you had your own bathroom and privacy to recover. After the operation I had no pain or discomfort. It can burn slightly when you first use the toilet but only for a day or so. I had to concentrate on passing urine at first and then I relaxed and could just go. I stopped wearing pads straight away and have had no leaks since.”

Brenda was advised not to drive for six weeks after her operation and next time she went on holiday she was pad free. She recommends other women suffering from leaks to get it sorted out: “Just go and see your GP. Yes, you may find it embarrassing but it is nothing they haven’t heard before and it can be sorted out so easily.” 

The surgeon's view - comments from Mr Sandy Gujral

"Re-do surgery for stress incontinence can be difficult and needs to be undertaken after careful assessment of the new symptoms as well as a full re-examination of the pelvic floor. I also undertake urodynamics prior to re-do surgery.

Brenda's case illustrates that patients do not need to suffer with poor quality of life secondary to incontinence, even if they have had multiple previous operations."

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