Rockdale Medical



New T.O.T. Sling is a Safer, More Effective Solution for Urinary Stress Incontinence 


Approximately 85% of all women in childbearing years and beyond experience some degree of stress urinary incontinence.  This leakage, which often occurs with coughing, laughing, sneezing, running or jumping is not only embarrassing but also tends to prohibit many activities of today's active woman. 

Until recently the most effective treatment has been the T.V.T. (Trans-vaginal tape) sling, which is vaginally implanted to provide a lift-and-secure mechanism to support the bladder. 

Like the T.V.T., the new T.O.T.  is also inserted vaginally in a ten minute outpatient surgery.  Patients generally leave the outpatient facility in an hour.

Several improvements in the procedure and the technology indicate that the T.O.T. sling is the method of choice. 

In a 'blind' procedure where the surgeon cannot visualize the area, the older T.V.T.  sling is attached on one side just behind the pubic bone. This placement has inherent risks due to its proximity to the bladder, bowel and major blood vessels.  Or the sling's placement may prevent urination, which has to be corrected in an additional procedure.   In addition, the T.V.T.  sling is manufactured of woven mesh, which over time may erode into the urethra.

The new T.O.T.  sling is attached underneath the pubic bone using a smaller, more easily managed needle.  Although the sling is placed in the same position as in the T.V.T., the chance of complications is greatly diminished during the surgical insertion because of a greater distance from the vital structures. 

Unlike the older sling, the central portion of the new T.O.T.  sling consists of material that can be absorbed, similar to dissolvable stitches.  After approximately 90 days of healing and the formation of supportive scar tissue, the central portion of the T.O.T. will have dissolved into the body. 

The T.O.T.  procedure, which has been used in Europe for more than two years, is rapidly replacing the older sling procedure.  Although no long term studies exist yet, the prognosis for this new option is excellent. 

Dr. Lyons worked with its manufacturer, Caldera Medical, in developing the technology.  Learn more about the procedure at

Incontinence May Be Only One Symptom of Pelvic Floor Defects

Childbirth is almost always the initial injury to the structural integrity of the pelvic floor.  This may begin to degrade the proper interdependent support required for all aspects of the female anatomy to function as designed. 

Often the initial complaint of incontinence spells additional problems which should be corrected earlier than later.  A great advantage offered by the Center for Women's Care is the correct diagnosis of pelvic floor integrity.  Each patient with incontinence is thoroughly evaluated.  If necessary, the entire pelvic floor can be re-supported in a single surgery. 

Although incontinence is often the most easily recognized symptom of pelvic floor defects, other conditions include prolapse, which is the herniation or collapse of the vaginal vault and/or uterus. 

Female pelvic tissues are dependent on estrogen for strength and support.  As a woman ages and estrogen depletes, the trauma produced during childbirth in earlier years can be compounded by weight gain, lifting or straining, and constipation. 

Only rarely does incontinence exist alone.  Most defects are clear upon vaginal examination.  Enhanced in-office diagnostics including ultrasound and urodynamics enable Dr. Lyons to assess accurately each patient's overall pelvic floor integrity. 

The overall health of women is dramatically improved by corrective medical attention early on in a single minimally-invasive procedure, because the condition often earmarked by incontinence will degenerate if left untreated.


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Center for Women's Care & Reproductive Surgery
located at Advanced Gynecology Associates
1380 Milstead Avenue, NE
Suite E
Conyers, GA 30012
Phone: (678) 609-4913
Fax: (678) 609-4923

This page last updated 04/23/2015