[Transobturator surgery for female urinary continence: from outside to inside or from inside to outside: a comparative anatomic study].
OBJECTIVE
Transobturator route is now largely used for the positioning of the supporting sub uretral tape in the surgical treatment of female urinary incontinence. This operation can be done using the original technique from the outside to the inside or by inside to outside. Our anatomic study evaluates the specific dangers of each


METHODS
Our study is based on the dissection of seven fresh bodies, therefore 14 obturator regions. The dissections were done after the positioning of the tape from outside to inside on one side and inside to outside on the other side. We particularly studied the distances separating the tape from the inferior pudendal vascular bundle and the posterior branch of the obturator nerve.


RESULTS
With the inside - outside technique there is a greater proximity between the path of the tape and the studied structures, therefore the risk of damage is greater.


CONCLUSIONS
The two techniques are not equivalent. There are less vascular and neurological risk using the original outside to inside technique.
Spinosa
Jean-Pierre
JP
Département de Gynécologie et Obstétrique, Hôpitaux Universitaires de Genève, Suisse. spinosa@deckpoint.ch
Dubuis
Pierre Yves
PY
Riederer
Beat
B
D002102:Cadaver; D005260:Female; D006801:Humans; D010388:Pelvis / Q000033:anatomy & histology*; D019736:Prostheses and Implants; D014549:Urinary Incontinence / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods