Well, it could be as simple as replacing an oring. The base of the PTT unit has a stainless steel pin (3/4" or so), that is drilled to allow PTT fluid to get from the starboard trim cylinder to the tilt cylinder and port trim cylinder. Each PTT cylinder is sealed by an Oring or two.
So you remove the keeper and drive out the pin and replace the orings.
However, sometimes the aluminum casting rots out and there is nothing to hold the Orings. That calls for replacement of the unit, or possible replacement of the trim cylinder.
Complete aftermarket units and used units are avail.