TOT (Transobturator Tape)

The TOT surgery is a minimally invasive (closed) surgical method primarily used for women experiencing stress urinary incontinence—urine leakage during coughing, sneezing, laughing, or physical activity. The goal of this procedure is to support the bladder outlet and permanently prevent urinary leakage.

What is Stress Urinary Incontinence?

Stress urinary incontinence occurs when the pelvic floor muscles weaken or the ligaments supporting the urethra become lax.
It is commonly seen in women after childbirth, menopause, aging, or pelvic surgeries. In this condition, the urethra cannot be adequately supported, causing urine leakage when abdominal pressure increases (for example, during coughing).

What is TOT Surgery?

In TOT surgery, a special synthetic tape (transobturator tape) is placed under the urethra to provide support and restore urinary control.
The tape integrates with the surrounding tissue over time and acts as a natural sling to prevent urine leakage.

The tape is inserted through the obturator foramen using small needles from the groin area and positioned under the mid-urethra.
The procedure typically takes 20–30 minutes and is performed under spinal or general anesthesia.

Advantages of TOT Surgery

Minimally invasive with small incisions and no visible scars.
Usually requires 1 day hospital stay.
Rapid recovery and quick return to daily activities.
Success rate ranges between 85–95%.
No stitches are needed; the tape integrates with tissue to provide long-term support.

Postoperative Period

Mild burning during urination or pelvic tension is normal in the first few days.
Patients generally return to normal activities within 1 week.
Heavy exercise, sexual activity, and strenuous efforts should be avoided for the first 4–6 weeks.
Restrictions are lifted after follow-up confirms normal urinary function and proper healing.

Who is Eligible?

Women diagnosed with stress urinary incontinence.
Patients without or with only mild pelvic organ prolapse.
Patients whose symptoms persist despite medication and pelvic floor exercises.

Success and Follow-up

TOT surgery is considered a gold standard surgical treatment for stress urinary incontinence.
With proper patient selection, accurate surgical technique, and regular follow-up, long-term success rates are very high.

In our clinic, TOT procedures are performed by experienced urologists using modern techniques under sterile conditions. The aim is to restore urinary control, improve quality of life, and regain confidence.