목적: Teach a new procedure. 방법: Modified transobturator tape (TOT), Canal TOT procedure was developed and published in Journal of Urology on 2009 and it was effective for mitigating the complications of the conventional TOT procedure in short term followup. Between October 2006 and December 2011, 205 consecutive women with stress and mixed urinary incontinence underwent canal TOT procedure. Conventional TOT usually requires making a single vaginal medial incision. However Canal TOT requires making two vaginal later incisions. It makes possible to palpate arcus tendinus fascia and ischiopubic ramus. This finger guided method could reduce bladder and vascular injury by well positioned mesh anatomically. 결과: A minimum 5-year followup was available in patients. Mesh erosion was recorded in two patients (1.0 %) and mesh was surgically removed. The subjective and objective cure rate at 5 year were 77.8 % and 94.5% respectively. And other complications such as dyspareunia(2.8%),de novo urgency and urinary retention, prolonged urethral catheterization(2.1 %) show similar incidence at conventional TOT in previous studies. 결론: Canal TOT procedure is an effective minimal invasive procedure with satisfactory results for female SUI in long term. Compared to previous other studies about mesh erosion after TOT procedure (1.6-4.7 %), this technique might be useful in preventing mesh erosion, because the mesh was anatomically well positioned, and minimize the invisible paravaginal defect cystocele using a finger-guided method. And it could be safe for patients who are obese or have prior vaginal surgery.