THE TRANSOBTURATOR TAPE PROCEDURE FOR THE TREATMENT OF FEMALE URODYNAMIC STRESS INCONTINENCE

S. Minaglia, B. Özel, R. Urwitz-Lane, S. Malik, J.J. Klutke

USC-Keck School of Medicine, Los Angeles, CA.

OBJECTIVE: To evaluate the short-term outcome, complications, and safety of the transobturator tape (TOT) procedure.

MATERIALS AND METHODS: Women with urodynamic stress incontinence underwent the TOT procedure as described by Delorme.  Data was prospectively collected from consecutive patients between October 2003 and August 2004.  Data included history, physical examination, urinalysis and culture, urodynamic studies, cystoscopy findings, and intra- and postoperative course.

RESULTS: All 100 patients who underwent the TOT procedure are included in this initial review.  In 60 patients with a median follow-up of 3 months, 91.6% of women reported subjective cure, 8.4% of women reported subjective improvement, and no women reported subjective failure of the TOT procedure.  The most common complications were 3 vaginal perforations, 2 cases of postoperative cystitis, and 2 needle cystotomies.  There was one case each of a vaginal hematoma, dissection urethrotomy, tape extrusion in the vagina, de novo urgency/frequency, and urinary retention requiring catheterization beyond 2 weeks postoperatively.

CONCLUSION: The TOT procedure is highly effective for surgical treatment of female urodynamic stress incontinence, and it may offer increased safety when compared to traditional retropubic slings.

Key Words: stress Incontinence, transobturator tape, complications

Disclosure –Consultant: J.J. Klutke, Mentor Corp.