Journal of SAFOMS

Register      Login

VOLUME 7 , ISSUE 2 ( July-December, 2019 ) > List of Articles

RESEARCH ARTICLE

Transobturator Tape: A Gold Standard for Stress Urinary Incontinence

Anuja Bhalerao, Neha V Harne, Krutika V Bhalerao

Keywords : Stress urinary incontinence, Tension free, Transobturator tape

Citation Information : Bhalerao A, Harne NV, Bhalerao KV. Transobturator Tape: A Gold Standard for Stress Urinary Incontinence. J South Asian Feder Menopause Soc 2019; 7 (2):86-89.

DOI: 10.5005/jp-journals-10032-1192

License: CC BY-NC 4.0

Published Online: 18-07-2020

Copyright Statement:  Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Objective: The objective of this paper is to evaluate the effectiveness of the transobturator vaginal tape (TOT) in the management of female stress urinary incontinence (SUI) and to analyze complications after 6 months of follow-up. Materials and methods: The study included women with SUI who had a TOT procedure in which the sling passes from the obturator foramen from outside to the inside, under regional anesthesia from January 2013 to December 2015. All women had a minimal follow-up of 6 months. The women were prospectively evaluated, and assessment was done by physical examination including pelvic examination, urinalysis, the cough stress test, and the Bonney\'s test. Results: Twenty-two consecutive women who fulfilled the inclusion criteria underwent the TOT procedure by a single surgeon. The mean age was 44.8 ± 4.2 years (range 37–53 years) and minimal follow-up was 6 months. The mean operative time was 25 ± 5 minutes (range 15–31 minutes), with an average amount of blood loss in all cases. Our results demonstrate a 90.90% cure or improvement rate after 6 months. Conclusion: The transobturator approach from outside to inside is an effective modality of treating SUI with low morbidity. However, longer follow-up in larger populations is needed to assess the reliability of this procedure.


PDF Share
  1. WS Reynolds, Dmochowski RR, Penson DF, et al. Epidemiology of stress urinary incontinence in women. Curr Urol Rep 2011;12(5): 370–376. DOI: 10.1007/s11934-011-0206-0.
  2. Guidelines for surgical management for female stress urinary incontinence: update (2009) American Urology Association. 2009.
  3. Hampel C, Weinhold D, Benken N, et al. Definition of overactive bladder and epidemiology of urinary incontinence. Urology 1997;50(6A Suppl):4–14. DOI: 10.1016/S0090-4295(97)00578-5.
  4. Ulmsten U, Petros P. Intravaginal slingplasty (IVS): an ambulatory procedure for treatment of female urinary incontinence. Scand J Urol Nephrol 1995;29(1):75–82. DOI: 10.3109/00365599509180543.
  5. Delorme E. Transobturator urethral suspension: mini invasive procedure in the treatment of stress urinary incontinence in women. Prog Urol 2001;11(6):1306–1313.
  6. De Leval J. Novel surgical technique for the treatment of female stress urinary incontinence: transobturator vaginal tape inside-Out. Eur Urol 2003;44(6):724–730. DOI: 10.1016/j.eururo.2003.09.003.
  7. DeTayrac R, Deffieux X, Droupy S, et al. A prospective randomized trial comparing tension-free vaginal tape and transobturator suburethral tape for surgical treatment of stress urinary incontinence. Am J Obstet Gynecol 2004;190(3):602–608. DOI: 10.1016/j.ajog.2003.09.070.
  8. Taweel WA, Rabah DM. Transobturator tape for female stress incontinence: follow-up after 24 months. Can Urol Assoc J 2010;4(1):33–36. DOI: 10.5489/cuaj.08118.
  9. Magon M, Chopra SV. Transobturator tape in treatment of stress urinary incontinence: it is time for a new gold standard. N Am J Med Sci 2012;4(5):226–230. DOI: 10.4103/1947-2714.95905.
  10. Moore RD, Miklos JR, Transobturator Sling: Combined analyses of 1 year follow up in 9 countries with 266 patients: XV Congress of the International Society for Gynecologic Endoscopy. April 1, Argentina: Buenos Aires; 2006.
  11. Purnichescu V, Cheret-Benoist A, Eboué C, et al. Surgical treatment for female stress urinary incontinence by transobturator tape (outside in). study of 70 cases. J Gynecol Obstet Biol Reprod (Paris) 2007;36(5):451–458. DOI: 10.1016/j.jgyn.2007.04.001.
  12. Barber MD, Gustilo-Ashby AM, Chen CC, et al. Perioperative complications and adverse events of the monarc transobturator tape, compared with the tension-free vaginal tape. Am J Obstet Gynecol 2006;195(6):1820–1825. DOI: 10.1016/j.ajog.2006.07.007.
  13. Tamussino K, Hanzal E, Kolle D, et al. Transobturator tapes for stress urinary incontinence: results of the austrian registry. Am J Obstet Gynecol 2007;197(6):634.e1. DOI: 10.1016/j.ajog.2007.08.018.
  14. Abouassaly R, Steinberg JR, Lemieux M, et al. Complications of tension-free vaginal tape surgery: a multi-institutional review. BJU Int 2004;94(1):110–113. DOI: 10.1111/j.1464-410X.2004.04910.x.
  15. Minaglia S, Ozel B, Klutke C, et al. Bladder injury during transobturator sling. Urology 2004;64(2):376–377. DOI: 10.1016/j.urology.2004.04.030.
  16. Abdel-Fattah M, Ramsay I, Pringle S, et al. Transobturator suburethral tapes in the management of urinary incontinence: success, safety and impact on sexual life. Gynecol Surg 2007;4:267–273. DOI: 10.1007/s10397-007-0303-8.
  17. Latthe P, Foon R, Toozs-Hobson P. Transobturator and retropubic tape procedures in stress urinary incontinence: a systematic review and meta-analysis of effectiveness and complications. BJOG 2007;114(5):522–531. DOI: 10.1111/j.1471-0528.2007.01268.x.
  18. Deval B, Ferchaux J, Berry R, et al. Objective and subjective cure rates after trans-obturator, tape (OBTAPE1) treatment of female urinary incontinence. Eur Urol 2006;49(2):373–377. DOI: 10.1016/j.eururo.2005.11.012.
  19. Siegel AL. Vaginal mesh extrusion associated with use of mentor transobturator sling. Urology 2005;66(5):995–999. DOI: 10.1016/j.urology.2005.05.015.
  20. Laurikainen E, Valpas A, Kivelä A, et al. Retropubic compared with transobturator tape placement in treatment of urinary incontinence: a randomised controlled trial. Obstet Gynecol 2007;109(1):4–11. DOI: 10.1097/01.AOG.0000249607.82768.a1.
  21. Giberti C, Gallo F, Cortese P, et al. Transobturator tape for treatment of female stress urinary incontinence: objective and subjective results after a mean follow-up of two years. Urology 2007;69(4):703–707. DOI: 10.1016/j.urology.2007.01.013.
  22. Meschia M, Pifarotti P, Bernasconi F, et al. Tension free vaginal tape: analysis of outcomes and complications in 404 stress incontinent women. Int Urogynecol J Pelvic Floor Dysfunct 2001;12(Suppl 2):S24–S27. DOI: 10.1007/s001920170008.
  23. Waltregny D, Gaspar Y, Reul O, et al. TVT-for the treatment of female stress urinary incontinence: results of aprospective study after a 3-year minimum follow-up. Eur Urol 2008;53(2):401–410. DOI: 10.1016/j.eururo.2007.08.021.
  24. Dobson A, Robert M, Swaby C, et al. Trans-obturator surgery for stress urinary incontinence: 1-year follow-up of a cohort of 52 women. Int Urogynecol J Pelvic Floor Dysfunct 2007;18(1):27–32. DOI: 10.1007/s00192-006-0115-9.
  25. Pankaj S, Singh M, Raghwendra KH, et al. An evaluation of use of tot in the current surgical management of female stress urinary incontinence. Int J Sci Study 2014;2(4):25–28.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.