Tension-free transobturator tape procedure for stress urinary incontinence.
OBJECTIVE
Recent data on the tension-free transobturator tape procedure for the treatment of female stress urinary incontinence are reviewed.


RESULTS
Although long-term data are not available, the effectiveness and safety of the tension-free transobturator tape procedure as reported during the past 5 years are very promising and this procedure is becoming a popular surgical treatment for female stress urinary incontinence. The continence rates obtained have been similar to those obtained using the retropubic tension-free vaginal tape on short-term follow-up. Clinical data as well as studies on cadaveric dissections suggest that complication rates can be decreased significantly with the transobturator approach. In the original tension-free transobturator tape procedure, the tape is inserted through the obturator foramen from the outside-to-inside direction (skin incision to vaginal incision). The inside-to-outside approach with passage of the tape from the vaginal incision to the obturator foramen has also been described.


CONCLUSIONS
The tension-free transobturator tape procedure provides a useful alternative to the retropubic tension-free vaginal tape approach while maintaining the principles of tension-free midurethral support. By avoiding the intrapelvic and retropubic passage, complications can be decreased. The effectiveness of this approach is similar to that of tension-free vaginal tape on short-term follow-up.
Ho
Mat H
MH
Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Harbor - UCLA Medical Center, David Geffen School of Medicine, University of California, Los Angeles, CA 90509-2910, USA. mho@obgyn.humc.edu
Lin
Lawrence L
LL
Haessler
Alexandra L
AL
Bhatia
Narender N
NN
D005260:Female; D006801:Humans; D011183:Postoperative Complications / Q000453:epidemiology; D019736:Prostheses and Implants / Q000009:adverse effects; D012449:Safety; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*