{"id":4436,"date":"2026-06-28T21:48:10","date_gmt":"2026-06-28T19:48:10","guid":{"rendered":"https:\/\/www.haab-urologie.fr\/test\/placement-of-suburethral-strips-tot-tvt"},"modified":"2026-10-14T22:44:40","modified_gmt":"2026-10-14T20:44:40","slug":"placement-of-suburethral-strips-tot-tvt","status":"publish","type":"expertise","link":"https:\/\/www.haab-urologie.fr\/en\/urologue-expertise\/placement-of-suburethral-strips-tot-tvt","title":{"rendered":"Placement of suburethral slings (TOT\/TVT)"},"content":{"rendered":"","protected":false},"excerpt":{"rendered":"<p>The gold standard technique for treating stress incontinence Suburethral sling placement is a minimally invasive surgical technique designed to correct stress urinary incontinence in women (and, in some cases, in\u2026<\/p>\n","protected":false},"featured_media":4511,"menu_order":0,"template":"","class_list":["post-4436","expertise","type-expertise","status-publish","has-post-thumbnail","hentry"],"acf":{"haab_subtitle":"The gold standard technique for treating stress incontinence","haab_intro":"Suburethral sling placement is a minimally invasive surgical technique designed to correct stress urinary incontinence in women (and, in some cases, in men).","haab_related_expertises":"","haab_related_besoins":"","haab_card_excerpt":"Suburethral sling placement is a minimally invasive surgical technique designed to correct stress urinary incontinence in women (and, in some cases, in men).","haab_form_shortcode":"","haab_primary_label":"consultation appointment","haab_primary_url":"https:\/\/www.doctolib.fr\/chirurgien-urologue\/paris\/francois-haab\/booking\/telehealth-suggestion?specialityId=177&profile_skipped=true&bookingFunnelSource=external_referral","haab_secondary_label":"","haab_secondary_url":"","haab_card_image":4511,"haab_hero_image":4153,"haab_videos":[{"url":"https:\/\/www.youtube.com\/watch?v=6BBT_N5sJD0","title":"My review in video"},{"url":"https:\/\/www.youtube.com\/watch?v=_TVBz-Pp3nw","title":"Suburethral sling: what precautions should be taken?"},{"url":"https:\/\/www.youtube.com\/watch?v=-xWhfdtQvdc","title":"How long does it last in women?"}],"haab_video_eyebrow":"","haab_video_section_title":"","haab_video_section_text":"","haab_faq_title":"FAQ \u2013 Frequently Asked Questions","haab_faq_items":[{"question":"What is the difference between TOT and TVT test strips?","answer":"Both are support slings placed under the urethra to treat stress incontinence. The TVT is inserted behind the pubic bone (retropubic approach), while the TOT is inserted through the obturator foramina (transobturator approach). The choice depends on your anatomy and medical history."},{"question":"Is the placement of the strip effective and long-lasting?","answer":"Yes. It is the gold standard treatment for female stress urinary incontinence, with 85 to 90% of women achieving good results maintained for more than 10 years. It is immediately effective upon resuming normal activities."},{"question":"What happens after the operation?","answer":"The procedure lasts approximately 20 minutes and is usually performed on an outpatient basis. Pain is minimal. It is recommended to avoid strenuous activity, baths, and sexual intercourse for 3 to 4 weeks."},{"question":"What precautions should be taken before installation?","answer":"Urodynamic testing is often performed to confirm the mechanism of incontinence. Specific risks (transient difficulty urinating, urinary urgency, sling exposure) are rare and are systematically explained during the consultation."}],"haab_sidebar_rdv_title":"","haab_doctor_band_title":"","haab_doctor_band_text":"","haab_doctor_band_points":null,"haab_doctor_band_image":"","haab_page_cta_title":"","haab_page_cta_text":"","haab_closing_highlights":null,"haab_blocks":[{"acf_fc_layout":"image_text_block","eyebrow":"","title":"What does this gesture consist of?","content":"<strong>Suburethral sling placement<\/strong> is a minimally invasive surgical technique used to correct <em>stress urinary incontinence<\/em> in women (and in some cases, in men). It aims to support the urethra so that it can remain closed during exertion (coughing, sneezing, sports, etc.). The sling acts like a hammock under the urethra: it is not under tension at rest but provides mechanical support when there is an increase in intra-abdominal pressure.","image":4153},{"acf_fc_layout":"video_section_block","eyebrow":"","title":"Presentation and background","text":"","video_url":"https:\/\/www.youtube.com\/watch?v=6BBT_N5sJD0"},{"acf_fc_layout":"image_text_block","eyebrow":"","title":"In what cases?","content":"<h3><strong>Indications<\/strong><\/h3> When can this technique be proposed?<ul><li> Persistent stress urinary incontinence despite well-conducted perineal rehabilitation. <u><a href=\"https:\/\/www.gynecologue-montpellier.com\/infos-gyn%C3%A9co\/incontinence-urinaire\/bandelette-sous-ur%C3%A9thrale-tot\/\" rel=\"noopener\">\r\n<\/a><\/u><\/li><li>Urinary incontinence during exertion that is bothersome in daily or social life (sports, laughing, coughing, sneezing). <u><a href=\"https:\/\/www.hartmann-direct.fr\/conseils-et-sante\/mieux-vivre-l-incontinence\/les-solutions\/les-traitements\/la-bandelette-tot-ou-tvt-contre-les-fuites-urinaires-d-effort\" rel=\"noopener\">\r\n<\/a><\/u><\/li><li>Patients seeking a long-lasting, minimally invasive solution with a quick return to normal activities. <u><a href=\"https:\/\/www.snitem.fr\/publications\/livrets-innovation\/le-livret-urologie\/\" rel=\"noopener\">\r\n<\/a><\/u><\/li><li>Discussed in cases of moderate to severe incontinence if the criteria are met (clinical examination, urodynamic assessment, sterile urine, etc.) <u><a href=\"https:\/\/www.uro-benjellounmed.com\/service-page\/pose-de-bandelette-sous-ur%C3%A9trale-tvt-tot\" rel=\"noopener\">\r\n<\/a><\/u><\/li><\/ul><hr \/><h3><strong>surgical technique<\/strong><\/h3> Here is how a sling placement procedure typically unfolds: <strong>1. Pre-operative preparation<\/strong><ul><li> Urodynamic assessment to confirm the type of incontinence (stress). <u><a href=\"https:\/\/www.gynecologue-montpellier.com\/infos-gyn%C3%A9co\/incontinence-urinaire\/bandelette-sous-ur%C3%A9thrale-tot\/\" rel=\"noopener\">\r\n<\/a><\/u><\/li><li>Urine analysis to ensure the absence of infection. <u><a href=\"https:\/\/www.urocean.org\/uro-gyn%C3%A9cologie-pelvi-p%C3%A9rin%C3%A9ologie\/les-traitements\/cure-d-incontinence-par-bandelette\/\" rel=\"noopener\">\r\n<\/a><\/u><\/li><li>Anesthesia consultation; choice of anesthesia (local, regional or general) according to the patient and the surgeon. <u><a href=\"https:\/\/www.urocean.org\/uro-gyn%C3%A9cologie-pelvi-p%C3%A9rin%C3%A9ologie\/les-traitements\/cure-d-incontinence-par-bandelette\/\" rel=\"noopener\">\r\n<\/a><\/u><\/li><\/ul><strong>2. Possible access routes<\/strong><ul><li> <strong>Retropubic approach<\/strong> (TVT \u2013 Tension-free Vaginal Tape): strip inserted through a vaginal incision, the ends pass behind the pubis. <u><a href=\"https:\/\/www.hartmann-direct.fr\/conseils-et-sante\/mieux-vivre-l-incontinence\/les-solutions\/les-traitements\/la-bandelette-tot-ou-tvt-contre-les-fuites-urinaires-d-effort\" rel=\"noopener\">\r\n<\/a><\/u><\/li><li><strong>Transobturator approach<\/strong> (TOT): strip inserted via vaginal incisions and exiting on the sides (thigh crease), avoiding the retropubic space. <u><a href=\"https:\/\/www.gynecologue-montpellier.com\/infos-gyn%C3%A9co\/incontinence-urinaire\/bandelette-sous-ur%C3%A9thrale-tot\/\" rel=\"noopener\">\r\n<\/a><\/u><\/li><\/ul><strong>3. Implantation of the strip<\/strong><ul><li> Small vaginal incision (a few centimeters) below the urethra. <u><a href=\"https:\/\/www.urocean.org\/uro-gyn%C3%A9cologie-pelvi-p%C3%A9rin%C3%A9ologie\/les-traitements\/cure-d-incontinence-par-bandelette\/\" rel=\"noopener\">\r\n<\/a><\/u><\/li><li>Passage of the strip (synthetic mesh, usually made of polypropylene). <u><a href=\"https:\/\/www.urofrance.org\/fileadmin\/medias\/afu\/communiques\/2017-01-11_communique-incontinence-et-bandelettes.pdf\" rel=\"noopener\">\r\n<\/a><\/u><\/li><li>\"Tension-free\" positioning: the sling is placed freely under the urethra, neither too tight (risk of retention) nor too loose (ineffective). <u><a href=\"https:\/\/www.gynecologue-montpellier.com\/infos-gyn%C3%A9co\/incontinence-urinaire\/bandelette-sous-ur%C3%A9thrale-tot\/\" rel=\"noopener\">\r\n<\/a><\/u><\/li><\/ul><strong>4. Duration, hospitalization, follow-up<\/strong><ul><li> The procedure usually lasts <strong>20 to 30 minutes<\/strong> . <u><a href=\"https:\/\/www.hartmann-direct.fr\/conseils-et-sante\/mieux-vivre-l-incontinence\/les-solutions\/les-traitements\/la-bandelette-tot-ou-tvt-contre-les-fuites-urinaires-d-effort\" rel=\"noopener\">\r\n<\/a><\/u><\/li><li>Hospitalization is often outpatient or of very short duration (day or night). <u><a href=\"https:\/\/www.hartmann-direct.fr\/conseils-et-sante\/mieux-vivre-l-incontinence\/les-solutions\/les-traitements\/la-bandelette-tot-ou-tvt-contre-les-fuites-urinaires-d-effort\" rel=\"noopener\">\r\n<\/a><\/u><\/li><\/ul>A quick return to normal activities, sometimes as early as the next day or in the following days, depending on the surgeon's instructions. <u><a href=\"https:\/\/www.azgroeninge.be\/fr\/patient\/traitement-et-recherches\/bandelette-sous-uretrale-en-cas-dincontinence-deffort\" rel=\"noopener\">\r\n<\/a><\/u>","image":3199},{"acf_fc_layout":"video_section_block","eyebrow":"Expertise","title":"Suburethral sling: what precautions should be taken?","text":"","video_url":"https:\/\/www.youtube.com\/watch?v=_TVBz-Pp3nw"},{"acf_fc_layout":"list_block","eyebrow":"","title":"Advantages of the minimally invasive technique","text":"","items":[{"item":"Less post-operative pain than with more invasive surgeries."},{"item":"Reduced scars, often barely visible."},{"item":"Quick return to everyday activities."},{"item":"Very good success rate for stress incontinence, especially in well-selected patients."}]},{"acf_fc_layout":"video_section_block","eyebrow":"Experience","title":"Suburethral sling: how long does it last in women?","text":"","video_url":"https:\/\/www.youtube.com\/watch?v=-xWhfdtQvdc"},{"acf_fc_layout":"list_block","eyebrow":"","title":"Specialist in subuterine sling placement","text":"","items":[{"item":"Proven experience in female urological surgery, including suburethral sling techniques."},{"item":"Mastery of minimally invasive techniques, TVT and TOT, with a focus on comfort, safety and long-term results."},{"item":"Diligent follow-up, careful post-operative care and adaptation according to progress."}]},{"acf_fc_layout":"text_block","eyebrow":"","title":"My journey in video","content":"I made this video to introduce myself and describe my background and expertise."}]},"_links":{"self":[{"href":"https:\/\/www.haab-urologie.fr\/en\/wp-json\/wp\/v2\/expertise\/4436","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.haab-urologie.fr\/en\/wp-json\/wp\/v2\/expertise"}],"about":[{"href":"https:\/\/www.haab-urologie.fr\/en\/wp-json\/wp\/v2\/types\/expertise"}],"version-history":[{"count":2,"href":"https:\/\/www.haab-urologie.fr\/en\/wp-json\/wp\/v2\/expertise\/4436\/revisions"}],"predecessor-version":[{"id":4493,"href":"https:\/\/www.haab-urologie.fr\/en\/wp-json\/wp\/v2\/expertise\/4436\/revisions\/4493"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.haab-urologie.fr\/en\/wp-json\/wp\/v2\/media\/4511"}],"wp:attachment":[{"href":"https:\/\/www.haab-urologie.fr\/en\/wp-json\/wp\/v2\/media?parent=4436"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}