Original Article

Evolution of the TOT OUT/IN technique: retropubic TOT. Morbidity and 5-year functional outcomes


Pelviperineology 2018;37(3):74-77


To describe the retropubic transobturator tape (TOTRP) technique for treating female stress urinary incontinence (SUI). To evaluate morbidity and 5-year functional outcomes.

Materials and methods:

A single-centre, observational, retrospective, single-surgeon study was carried out. The patients included had a TOTRP placed between 2009 and 2012. The originality of the technique is the horizontal transobturator and non-oblique route of the ancillary. The perioperative characteristics were recorded. The functional outcomes were evaluated pre-surgery and between March and April 2016 using the Urinary Symptom Profile (USP) questionnaire.


88 patients were evaluated after 5 years. The lost-to-follow-up rate was 7.4%. No perioperative complications were found. There was no tape erosion, no pain over the 5 years. The SUI was improved in 92% of the cases and cured in 72.7% of cases. The de novo overactive bladder (OAB) rate was 15.9%. In patients presenting with pre-operative mixed UI, the SUI was improved in 100% of cases and cured in 63.6% of cases. The OAB was improved in 45.5% of cases.


The TOTRP is associated with an absence of perioperative morbidity and no erosion in the long term. The TOTRP technique gives functional outcomes after 5 years that are similar to the data in the literature for the conventional TOT technique, whilst reducing morbidity.

Keywords: Functional Outcomes,Morbidity,Questionnaire Urinary Symptom Profile symptom,Retropubic TOT,Stress urinary incontinence