<![CDATA[HIGHLIGHTS Transobturator tape (TOT) surgery resulted in a high short-term subjective and objective cure rate (87.5%) and a 100% improvement rate in Indonesian women with moderate-to-severe stress urinary incontinence. This study provides the first objective, pad-test–based evidence demonstrating the effectiveness and safety of TOT surgery in an Indonesian population treated at a national referral center. The significant reduction in SUI severity observed after TOT surgery supports its clinical applicability and reinforces its role as a primary surgical option for stress urinary incontinence in resource-diverse settings. ABSTRACT Objective: Stress urinary incontinence (SUI) is a common condition that significantly impairs women's quality of life. Although the transobturator tape (TOT) procedure is an established surgical treatment for SUI, evidence regarding its outcomes in the Indonesian population remains limited. This study evaluated the effectiveness and safety of TOT surgery in Indonesian women with moderate-to-severe SUI. Materials and Methods: A retrospective single-arm pre-post cohort study was conducted on women who underwent TOT surgery between January 2021 and December 2023 at Dr. Cipto Mangunkusumo Hospital, Jakarta. Subjective and objective outcomes were assessed using the International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form (ICIQ-UI SF) and the one-hour pad test before surgery and 3 months postoperatively. Data were analyzed using paired-samples t-test or Wilcoxon signed-rank test. Results: Sixteen patients met the inclusion criteria, comprising 8 patients with moderate SUI and 8 with severe SUI. The mean age was 55.6 ± 8.2 years, and the mean body mass index was 27.1 ± 3.5 kg/m². At 3 months, 14 patients (87.5%) achieved objective cure, while the remaining two (12.5%) improved from severe to mild SUI. Median pad test weight decreased significantly from 42.5 g (IQR: 16.5–68.5) to 2.0 g (IQR: 1.0–4.5) (p < 0.001). No major intraoperative complications occurred, and all patients reported complete resolution of subjective symptoms based on ICIQ-UI SF assessment. Conclusion: TOT surgery is a safe and highly effective treatment for moderate-to-severe SUI in Indonesian women, providing excellent short-term objective and subjective outcomes and supporting its broader implementation in clinical practice. ]]>
