Leaking urine is far more common than most women realise, and it is very treatable. When it happens with coughing, laughing or exercise — called stress incontinence — a short operation such as the TOT procedure can be highly effective once simpler measures have been tried.
Types of incontinence
- Stress incontinence — leaking when you cough, laugh, sneeze or exercise, due to weakened support of the bladder neck.
- Urge incontinence — a sudden, strong need to pass urine, sometimes with leaking.
- Mixed — a combination of both.
Identifying the type matters, because the treatments differ.
First-line treatment
For most women, the first step is non-surgical: pelvic floor (Kegel) exercises, bladder training, and lifestyle measures. These are effective for many women and have no downsides. See our pelvic floor health guide.
What is the TOT procedure?
TOT (trans-obturator tape) is a short operation for stress incontinence. A narrow supportive sling is placed under the urethra to restore support, so it no longer leaks under pressure. It is minimally invasive, usually done as a day or short-stay procedure.
Recovery
Most women return home the same day or after one night and to light activity within a couple of weeks, avoiding heavy lifting for a period as advised. Your team gives clear, written aftercare.
Is surgery always needed?
No. Surgery is considered only when pelvic floor therapy and conservative measures have not given enough improvement, and when stress incontinence is the main problem. Your surgeon explains whether you are a good candidate.
Surgery is not the only option. For stress incontinence we also offer a non-surgical laser treatment (ALMA FemiLift, fractional CO2), performed by Op. Dr. Meryem Gökkaya Uçarer. It is chosen above all by women who would rather not have an operation, or whose leakage is not severe. The usual plan is three sessions, one a month, at €390 per session; the number of sessions depends on the degree of leakage and is decided at the examination. For this indication the laser is a medical treatment, not an aesthetic procedure. Where leakage is severe, or prolapse (cystocele/rectocele) is also present, the surgical option is the appropriate one.
See the full urogynaecology guide and our price list.
Where the operation takes place
Every surgical procedure we perform — whether it is done under local anaesthetic or under general anaesthesia — is carried out in the operating theatre of our partner hospital, Acıbadem, an internationally recognised, JCI-accredited hospital group. Our clinic in Bahçeşehir is for consultations, follow-up and non-surgical treatments such as vaginal laser, PRP (O-Shot) and intimate lightening. Local anaesthetic changes what you feel during the operation; it never changes where the operation is done. Sedation and general anaesthesia are always given at the hospital, never at the clinic.
Sources: NICE urinary incontinence guideline, RCOG, ACOG. This article is for general education and does not replace a medical consultation. Reviewed by Assist. Prof. Dr. Muzaffer Uçarer (Obstetrics & Gynaecology), UCARER Women’s Health, Istanbul.
