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The Role of Transobturator Tape (TOT) Operation in the Treatment of Pelvic Organ Prolapse and Stress Urinary Incontinence

Year 2025, Issue: 26, 562 - 572, 31.08.2025
https://doi.org/10.38079/igusabder.1582478

Abstract

Aim: This study aimed to assess the efficacy and safety of the Transobturator Tape (TOT) procedure in treating stress urinary incontinence (SUI), both independently and when combined with pelvic floor reconstruction surgery.
Method: In a retrospective analysis, data were collected from 251 female patients treated for SUI at Health Sciences University, İstanbul Bağcılar Training and Research Hospital, from April 2020 to April 2022. Patients were divided into two groups based on the surgical approach: TOT alone and TOT with pelvic reconstruction. The Patient Global Impression of Improvement (PGI-I) scale was used to evaluate patient-reported outcomes, measuring improvements in symptoms and quality of life post-surgery.
Results: The results demonstrated a high success rate in SUI management, with a significant percentage of patients reporting the absence of incontinence after surgery. Notably, cases with TOT alone showed slightly higher success rates and patient satisfaction compared to those combined with pelvic reconstruction. The outcomes aligned with existing research, supporting TOT as an effective intervention in diverse surgical settings.
Conclusion: TOT is a highly effective treatment for SUI, with its use either alone or in combination with pelvic reconstruction. The study emphasizes the importance of individualized surgical approaches based on patient-specific characteristics, highlighting the need for thorough preoperative assessments and patient counseling to optimize outcomes.

References

  • 1. Barber MD. Pelvic organ prolapse. BMJ. 2016;354. doi: 10.1136/bmj.i3853.
  • 2. Abed H, Rogers RG. Urinary incontinence and pelvic organ prolapse: diagnosis and treatment for the primary care physician. Med Clin North Am. 2008;92(5):1273-1293.
  • 3. Bai SW, Jeon MJ, Kim JY, Chung KA, Kim SK, Park KH. Relationship between stress urinary incontinence and pelvic organ prolapse. Int Urogynecol J. 2002;13:256-260.
  • 4. Allen-Brady K, Chua JW, Cuffolo R, Koch M, Sorrentino F, Cartwright R. Systematic review and meta-analysis of genetic association studies of pelvic organ prolapse. Int Urogynecol J. 2022;33(1):67-82. doi: 10.1007/s00192-021-04791-5.
  • 5. Altman D, Forsman M, Falconer C, Lichtenstein P. Genetic influence on stress urinary incontinence and pelvic organ prolapse. Eur Urol. 2008;54(4):918-923.
  • 6. Arts-de Jong M, Van Altena AM, Aalders CIM, Dijkhuizen FPHLJ, Van Balken MR. Improvement of sexual function after transobturator tape procedure in women with stress urinary incontinence. Gynecol Surg. 2011;8:315-319. doi: 10.1007/s10397-011-0654-y.
  • 7. Collins S, Lewicky-Gaupp C. Pelvic organ prolapse. Gastroenterol Clin North Am. 2022;51(1):177-193. doi: 10.1016/j.gtc.2021.12.007.
  • 8. Barber MD, Maher C. Epidemiology and outcome assessment of pelvic organ prolapse. Int Urogynecol J. 2013;24:1783-1790. doi: 10.1007/s00192-013-2169-9.
  • 9. Borstad E, Abdelnoor M, Staff AC, Kulseng-Hanssen S. Surgical strategies for women with pelvic organ prolapse and urinary stress incontinence. Int Urogynecol J. 2010;21:179-186.
  • 10. Bø K. Pelvic floor muscle training in treatment of female stress urinary incontinence, pelvic organ prolapse and sexual dysfunction. World J Urol. 2012;30:437-443.
  • 11. Brasoveanu S, Ilina R, Balulescu L, Pirtea M, Secosan C, Grigoraș D, Pirtea L. Evaluating patient preferences and clinical outcomes in stress urinary incontinence treatment: A short-term follow-up study of the transobturator tape procedure and pubourethral ligament plication—a minimally invasive technique. J Pers Med. 2023;14(1):34.
  • 12. Chapple CR, Cruz F, Deffieux X, et al. Consensus statement of the European Urology Association and the European Urogynaecological Association on the use of implanted materials for treating pelvic organ prolapse and stress urinary incontinence. Eur Urol. 2017;72(3):424-431. doi: 10.1016/j.eururo.2017.01.035.
  • 13. Fleischer K, Thiagamoorthy G. Pelvic organ prolapse management. Post Reprod Health. 2020;26(2):79-85. doi: 10.1177/2053369120925566.
  • 14. Giberti C, Gallo F, Cortese P, Schenone M. Transobturator tape for treatment of female stress urinary incontinence: objective and subjective results after a mean follow-up of two years. Urology. 2007;69(4):703-707. doi: 10.1016/j.urology.2007.01.073.
  • 15. Jelovsek JE, Maher C, Barber MD. Pelvic organ prolapse. Lancet. 2007;369(9566):1027-1038. doi: 10.1016/S0140-6736(07)60462-0.
  • 16. Lin L, Huang MC, Su TH, Lau HH. Comparison between tension-free vaginal tape and transobturator tape in treating stress urinary incontinence after vaginal mesh surgery. Taiwan J Obstet Gynecol. 2018;57(4):528-531. doi: 10.1016/j.tjog.2018.04.014.
  • 17. Han L, Wang L, Wang Q, Li H, Zang H. Association between pelvic organ prolapse and stress urinary incontinence with collagen. Exp Ther Med. 2014;7(5):1337-1341.
  • 18. Carroll L, O’Sullivan C, Perrotta C, Fullen B. Pelvic organ prolapse: the lived experience. PLoS One. 2022;17(11). doi: 10.1371/journal.pone.0276788.
  • 19. Kim HG, Park HK, Paick SH, Choi WS. Comparison of effectiveness between tension-free vaginal tape (TVT) and trans-obturator tape (TOT) in patients with stress urinary incontinence and intrinsic sphincter deficiency. PLoS One. 2016;11(5).
  • 20. Jeon MJ, Chung DJ, Park JH, Kim SK, Kim JW, Bai SW. Surgical therapeutic index of tension-free vaginal tape and transobturator tape for stress urinary incontinence. Gynecol Obstet Invest. 2008;65(1):41-46. doi: 10.1159/000107935.
  • 21. Lo TS. Combined pelvic reconstructive surgery and transobturator tape (monarc) in women with advanced prolapse and urodynamic stress incontinence: A case control series. J Minim Invasive Gynecol. 2009;16(2):163-168. doi: 10.1016/j.jmig.2008.12.004.
  • 22. Carroll L, O’Sullivan C, Doody C, Perrotta C, Fullen B. Biopsychosocial profile of women with pelvic organ prolapse: A systematic review. Womens Health (Lond). 2023;19:17455057231181012. doi: 10.1177/17455057231181012.
  • 23. Mayekar RV, Bhosale AA, Kandhari KV, Nandanwar YS, Shaikh SS. A study of transobturator tape in stress urinary incontinence. Urol Ann. 2017;9(1):9-13.
  • 24. Mori da Cunha MG, Mackova K, Hympanova LH, Bortolini MAT, Deprest J. Animal models for pelvic organ prolapse: Systematic review. Int Urogynecol J. 2021;32:1331-1344. doi: 10.1007/s00192-020-04599-y.
  • 25. Pang H, Zhang L, Han S, et al. A nationwide population-based survey on the prevalence and risk factors of symptomatic pelvic organ prolapse in adult women in China—a pelvic organ prolapse quantification system-based study. BJOG. 2021;128(8):1313-1323.
  • 26. Chen B, Wen Y, Polan ML. Elastolytic activity in women with stress urinary incontinence and pelvic organ prolapse. Neurourol Urodyn. 2004;23(2):119-126.
  • 27. Iglesia CB, Smithling KR. Pelvic organ prolapse. Am Fam Physician. 2017;96(3):179-185.
  • 28. Giberti C, Gallo F, Cortese P, Schenone M. Transobturator tape for treatment of female stress urinary incontinence: objective and subjective results after a mean follow-up of two years. Urology. 2007;69(4):703-707. doi: 10.1016/j.urology.2007.01.073.

Transobturator Bant (TOT) Operasyonunun Pelvik Organ Prolapsusu ve Stres Üriner İnkontinans Tedavisindeki Rolü

Year 2025, Issue: 26, 562 - 572, 31.08.2025
https://doi.org/10.38079/igusabder.1582478

Abstract

Amaç: Bu çalışmanın amacı, stres üriner inkontinansın (SÜİ) tedavisinde transobturator bant (TOT) yönteminin, tek başına veya pelvik taban rekonstrüksiyon cerrahisiyle birlikte kullanıldığında etkinliğini ve güvenliğini değerlendirmektir.
Yöntem: Retrospektif olarak gerçekleştirilen bu çalışmada, Nisan 2020 - Nisan 2022 tarihleri arasında Sağlık Bilimleri Üniversitesi, İstanbul Bağcılar Eğitim ve Araştırma Hastanesi’nde SÜİ tedavisi gören 251 kadın hastanın verileri incelendi. Hastalar, TOT tek başına uygulananlar ve TOT ile pelvik rekonstrüksiyon yapılanlar olmak üzere iki gruba ayrıldı. Hasta Küresel İyileşme İzlenimi (PGI-I) ölçeği ile cerrahi sonrası semptomlar ve yaşam kalitesindeki iyileşmeler değerlendirildi.
Bulgular: Sonuçlar, SÜİ yönetiminde yüksek bir başarı oranı göstermiş olup, cerrahi sonrası önemli bir hasta grubunda inkontinansın sona erdiği bildirilmiştir. Sadece TOT uygulanan hastalarda, pelvik rekonstrüksiyon eklenen vakalara kıyasla başarı oranı ve hasta memnuniyeti biraz daha yüksek bulunmuştur. Sonuçlar, mevcut literatürle uyumlu olarak TOT yönteminin çeşitli cerrahi bağlamlarda etkili bir müdahale olduğunu desteklemektedir.
Sonuç: TOT yöntemi, SÜİ için son derece etkili bir tedavi olup gerek tek başına gerekse pelvik rekonstrüksiyon ile birlikte kullanılabilir. Çalışma, hasta özelliklerine göre bireyselleştirilmiş cerrahi yaklaşımların önemini vurgulayarak, başarılı sonuçlar için ayrıntılı preoperatif değerlendirme ve hasta bilgilendirmesinin gerekliliğine dikkat çekmektedir.

References

  • 1. Barber MD. Pelvic organ prolapse. BMJ. 2016;354. doi: 10.1136/bmj.i3853.
  • 2. Abed H, Rogers RG. Urinary incontinence and pelvic organ prolapse: diagnosis and treatment for the primary care physician. Med Clin North Am. 2008;92(5):1273-1293.
  • 3. Bai SW, Jeon MJ, Kim JY, Chung KA, Kim SK, Park KH. Relationship between stress urinary incontinence and pelvic organ prolapse. Int Urogynecol J. 2002;13:256-260.
  • 4. Allen-Brady K, Chua JW, Cuffolo R, Koch M, Sorrentino F, Cartwright R. Systematic review and meta-analysis of genetic association studies of pelvic organ prolapse. Int Urogynecol J. 2022;33(1):67-82. doi: 10.1007/s00192-021-04791-5.
  • 5. Altman D, Forsman M, Falconer C, Lichtenstein P. Genetic influence on stress urinary incontinence and pelvic organ prolapse. Eur Urol. 2008;54(4):918-923.
  • 6. Arts-de Jong M, Van Altena AM, Aalders CIM, Dijkhuizen FPHLJ, Van Balken MR. Improvement of sexual function after transobturator tape procedure in women with stress urinary incontinence. Gynecol Surg. 2011;8:315-319. doi: 10.1007/s10397-011-0654-y.
  • 7. Collins S, Lewicky-Gaupp C. Pelvic organ prolapse. Gastroenterol Clin North Am. 2022;51(1):177-193. doi: 10.1016/j.gtc.2021.12.007.
  • 8. Barber MD, Maher C. Epidemiology and outcome assessment of pelvic organ prolapse. Int Urogynecol J. 2013;24:1783-1790. doi: 10.1007/s00192-013-2169-9.
  • 9. Borstad E, Abdelnoor M, Staff AC, Kulseng-Hanssen S. Surgical strategies for women with pelvic organ prolapse and urinary stress incontinence. Int Urogynecol J. 2010;21:179-186.
  • 10. Bø K. Pelvic floor muscle training in treatment of female stress urinary incontinence, pelvic organ prolapse and sexual dysfunction. World J Urol. 2012;30:437-443.
  • 11. Brasoveanu S, Ilina R, Balulescu L, Pirtea M, Secosan C, Grigoraș D, Pirtea L. Evaluating patient preferences and clinical outcomes in stress urinary incontinence treatment: A short-term follow-up study of the transobturator tape procedure and pubourethral ligament plication—a minimally invasive technique. J Pers Med. 2023;14(1):34.
  • 12. Chapple CR, Cruz F, Deffieux X, et al. Consensus statement of the European Urology Association and the European Urogynaecological Association on the use of implanted materials for treating pelvic organ prolapse and stress urinary incontinence. Eur Urol. 2017;72(3):424-431. doi: 10.1016/j.eururo.2017.01.035.
  • 13. Fleischer K, Thiagamoorthy G. Pelvic organ prolapse management. Post Reprod Health. 2020;26(2):79-85. doi: 10.1177/2053369120925566.
  • 14. Giberti C, Gallo F, Cortese P, Schenone M. Transobturator tape for treatment of female stress urinary incontinence: objective and subjective results after a mean follow-up of two years. Urology. 2007;69(4):703-707. doi: 10.1016/j.urology.2007.01.073.
  • 15. Jelovsek JE, Maher C, Barber MD. Pelvic organ prolapse. Lancet. 2007;369(9566):1027-1038. doi: 10.1016/S0140-6736(07)60462-0.
  • 16. Lin L, Huang MC, Su TH, Lau HH. Comparison between tension-free vaginal tape and transobturator tape in treating stress urinary incontinence after vaginal mesh surgery. Taiwan J Obstet Gynecol. 2018;57(4):528-531. doi: 10.1016/j.tjog.2018.04.014.
  • 17. Han L, Wang L, Wang Q, Li H, Zang H. Association between pelvic organ prolapse and stress urinary incontinence with collagen. Exp Ther Med. 2014;7(5):1337-1341.
  • 18. Carroll L, O’Sullivan C, Perrotta C, Fullen B. Pelvic organ prolapse: the lived experience. PLoS One. 2022;17(11). doi: 10.1371/journal.pone.0276788.
  • 19. Kim HG, Park HK, Paick SH, Choi WS. Comparison of effectiveness between tension-free vaginal tape (TVT) and trans-obturator tape (TOT) in patients with stress urinary incontinence and intrinsic sphincter deficiency. PLoS One. 2016;11(5).
  • 20. Jeon MJ, Chung DJ, Park JH, Kim SK, Kim JW, Bai SW. Surgical therapeutic index of tension-free vaginal tape and transobturator tape for stress urinary incontinence. Gynecol Obstet Invest. 2008;65(1):41-46. doi: 10.1159/000107935.
  • 21. Lo TS. Combined pelvic reconstructive surgery and transobturator tape (monarc) in women with advanced prolapse and urodynamic stress incontinence: A case control series. J Minim Invasive Gynecol. 2009;16(2):163-168. doi: 10.1016/j.jmig.2008.12.004.
  • 22. Carroll L, O’Sullivan C, Doody C, Perrotta C, Fullen B. Biopsychosocial profile of women with pelvic organ prolapse: A systematic review. Womens Health (Lond). 2023;19:17455057231181012. doi: 10.1177/17455057231181012.
  • 23. Mayekar RV, Bhosale AA, Kandhari KV, Nandanwar YS, Shaikh SS. A study of transobturator tape in stress urinary incontinence. Urol Ann. 2017;9(1):9-13.
  • 24. Mori da Cunha MG, Mackova K, Hympanova LH, Bortolini MAT, Deprest J. Animal models for pelvic organ prolapse: Systematic review. Int Urogynecol J. 2021;32:1331-1344. doi: 10.1007/s00192-020-04599-y.
  • 25. Pang H, Zhang L, Han S, et al. A nationwide population-based survey on the prevalence and risk factors of symptomatic pelvic organ prolapse in adult women in China—a pelvic organ prolapse quantification system-based study. BJOG. 2021;128(8):1313-1323.
  • 26. Chen B, Wen Y, Polan ML. Elastolytic activity in women with stress urinary incontinence and pelvic organ prolapse. Neurourol Urodyn. 2004;23(2):119-126.
  • 27. Iglesia CB, Smithling KR. Pelvic organ prolapse. Am Fam Physician. 2017;96(3):179-185.
  • 28. Giberti C, Gallo F, Cortese P, Schenone M. Transobturator tape for treatment of female stress urinary incontinence: objective and subjective results after a mean follow-up of two years. Urology. 2007;69(4):703-707. doi: 10.1016/j.urology.2007.01.073.
There are 28 citations in total.

Details

Primary Language English
Subjects Models of Care and Place of Birth, Obstetrics and Gynocology Nursing
Journal Section Articles
Authors

Teymur Bornaun 0009-0007-8081-8003

Early Pub Date August 30, 2025
Publication Date August 31, 2025
Submission Date November 10, 2024
Acceptance Date July 7, 2025
Published in Issue Year 2025 Issue: 26

Cite

JAMA Bornaun T. The Role of Transobturator Tape (TOT) Operation in the Treatment of Pelvic Organ Prolapse and Stress Urinary Incontinence. IGUSABDER. 2025;:562–572.

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