Dr Jasdev Singh
Mid-Urethral Sling (TVT / TOT)
A narrow tape placed under the urethra supports it when you cough, laugh or exercise, to reduce leaks caused by stress incontinence.
Urinary Incontinence
Supporting the bladder outlet to reduce leaks when you cough or move
Stress urinary incontinence means leaking urine when pressure rises, such as when coughing, sneezing, lifting or exercising. A midurethral sling is a narrow strip of synthetic tape placed under the urethra, the tube that carries urine out. TVT and TOT are two ways of placing it.
Leaking can affect confidence, exercise and intimacy. It is common and treatable, and nothing to be embarrassed about.
Dr Jasdev discusses pelvic floor exercises and other options first, along with the benefits and risks of tape surgery.
Symptoms understood first
Leaking, bulging or discomfort is assessed carefully, including how much it affects your daily life.
Simpler options considered too
Pelvic floor exercises, physiotherapy and other treatments without surgery are discussed alongside operations.
Recovery planned in advance
You will know what to expect after the procedure and when your review is due.
What sling surgery may offer
- Fewer leaks with coughing, sneezing or exercise
- A short procedure with a quick recovery
- An open discussion of tape risks before you decide
How your care is planned
Each stage is explained so you understand the cause of your symptoms, your options and what recovery involves. You can take time to decide.
Confirm the type of incontinence with tests
Try pelvic floor physiotherapy first where suitable
Place the tape and review your recovery
How the procedure works
Under anaesthetic, a small cut is made in the vagina under the urethra. The tape is passed either behind the pubic bone (TVT) or through the groin (TOT). It sits loosely under the urethra, without tension. The procedure usually takes around thirty minutes.
Who may benefit
Women with stress incontinence that has not improved enough with pelvic floor exercises. It suits women who have completed their family, or who understand how a later pregnancy may affect the result. It is usually not the first choice for women planning more pregnancies.
What to expect
Many women go home the same day or the next. You should avoid heavy lifting for several weeks. Your bladder emptying is checked before you leave, and you will have a review visit.
How Dr Jasdev works with you
He brings gynaecological surgical experience and a calm, private approach to symptoms that many women find hard to talk about. Plans follow current evidence and your own priorities. You will have time to ask questions before anything is decided. Women see him from Kuala Lumpur and across Malaysia.
What to bring to your appointment
These details help Dr Jasdev understand your symptoms and plan the right tests or treatment. If you cannot find everything, bring what you have.
- A bladder diary of leaks and toilet visits
- Details of any previous bladder or pelvic surgery
- A list of your medicines
What women often ask
Bladder and pelvic floor problems are common, yet many women wait years before asking about them. These questions can help you start.
Is my leaking caused by stress or urge incontinence?
Should I try physiotherapy first?
What are the risks of tape surgery?
What if I want more children?
Your questions about sling surgery
What is a midurethral sling?
It is a narrow tape placed under the urethra to support it and reduce leaking during coughing, sneezing or exercise.
Who is it suitable for?
Women with stress incontinence not helped enough by pelvic floor exercises. Other types of incontinence need different treatment.
What tests are needed first?
A bladder diary, a urine test and an examination. Bladder pressure tests, called urodynamics, may be advised in some cases.
Is it painful or risky?
Mild discomfort is common for a few weeks. Risks include bladder injury, difficulty emptying, groin or pelvic pain, and the tape wearing through the vaginal wall. These are discussed fully before you decide.
Why see Dr Jasdev for this?
He discusses all your options openly, including treatment without surgery, so your choice is fully informed.
How do I book?
Call or WhatsApp the clinic. Keeping a three day bladder diary before your visit is helpful.
This page is general information and does not replace a consultation. Whether a procedure suits you, and its risks, recovery and alternatives, should be discussed with Dr Jasdev based on your own history.
Get help with bladder leaks
Book a consultation to discuss your options.