Residents performance in transobturator tape procedures for stress urinary incontinence.
OBJECTIVE
The purpose of this study was to investigate the operative time, surgical complications and patient outcomes of the TOT surgery performed by an experienced surgeon compared to those performed by a senior resident under proper supervision by a senior surgeon.


METHODS
A prospective, open label, randomized study was conducted at the department of urogynecology of the Ministry of Health Ankara Etlik Maternity and Women's Health Teaching Research Hospital between June 2003-June 2004. The study included 60 women who had stress urinary incontinence. Patients were randomly allocated to either the TOT surgery performed by an experienced surgeon group (Group 1, n=30) or the TOT surgery performed by a senior resident under proper supervision by a senior surgeon group (Group 2, n=30). The operative time, intraoperative and postoperative complications, intraoperative blood loss and the effectivity of the TOT procedure were recorded by a senior surgeon who did not participate to the operation.


RESULTS
The study was completed by 55 women. Baseline characteristics were comparable between the two groups. The mean operative time was significantly long in Group 2 compared with Group 1 (27 min [15-48]; 13 min [7-22], respectively). There was no difference between the Groups 1 and 2 in terms of the intraoperative and postoperative complications. No bladder injury was noted in Group 1. One bladder injury was observed in Group 2 and the bladder was repaired in the usual form by the assisting senior surgeon. Urinary retention was observed in two patients in Group 2 and the tapes were cut 7 days after the operation. Both of the patients have been dry since the intervention. The mean follow up period was 30 months. After the follow up period, there were no statistically significant differences in terms of cure, partial recovery and failure between two groups.


CONCLUSIONS
There is no difference in the outcome when TOT is performed by residents under proper supervision.
Sivaslioglu
Ahmet Akin
AA
Department of Urogynecology, Ministry of Health Ankara Etlik Maternity and Women's Health Teaching Research Hospital, Turkey. aas@tr.net
Demir
Berfu
B
Dolen
Ysmail
Y
Gelisen
Orhan
O
Haberal
Ali
A
D000328:Adult; D002983:Clinical Competence; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D008505:Medical Staff, Hospital; D008875:Middle Aged; D011446:Prospective Studies; D053825:Suburethral Slings / Q000009:adverse effects*; D014421:Turkey; D014550:Urinary Incontinence, Stress / Q000601:surgery*