title: TVT-S in the U position--anatomical study.
abstract: OBJECTIVE
  The objective is to describe the anatomical position of tension-free vaginal tape Secur (TVT-S) in the U position regarding possible injury and fixation site.
  
  
  METHODS
  We placed TVT-S inserters bilaterally in 13 embalmed and five fresh frozen female bodies. After dissection, we measured distances from the obturator bundle.
  
  
  RESULTS
  In embalmed bodies, the mean distance of TVT-S from the obturator bundle was 2.83 cm (standard deviation (SD) 0.87 cm) on the left, 2.92 cm (SD 1.24 cm) on the right. Perforation of the fascia of obturator internus muscle occurred in 38.5%. In fresh frozen bodies, results were fundamentally similar (p > 0.05).
  
  
  CONCLUSIONS
  There is a risk of injury to the obturator bundle and urinary bladder during TVT-S; however, there is a significant risk of inserting the TVT-S inserter outside the obturator internus muscle (into the lesser pelvis). The position of TVT-S does not change significantly after legs mal-positioning.
authors.affiliation: First Faculty of Medicine and General Teaching Hospital, Department of Gynaecology and Obstetrics, Charles University in Prague, Apolinarska 18, Prague 2, 12000, Czech Republic. petr.hubka@centrum.cz
authors.forename: Petr
authors.initials: P
authors.lastname: Hubka
authors.forename: Ondrej
authors.initials: O
authors.lastname: Nanka
authors.forename: Alois
authors.initials: A
authors.lastname: Martan
authors.forename: Milos
authors.initials: M
authors.lastname: Grim
authors.forename: Jana
authors.initials: J
authors.lastname: Zvarova
authors.forename: Jaromir
authors.initials: J
authors.lastname: Masata
mesh_terms: D005260:Female; D005404:Fixatives; D005557:Formaldehyde; D013509:Gynecologic Surgical Procedures; D006801:Humans; D009776:Obturator Nerve / Q000033:anatomy & histology; D010388:Pelvis / Q000098:blood supply* / Q000294:innervation; D053825:Suburethral Slings; D001743:Urinary Bladder / Q000033:anatomy & histology; D014550:Urinary Incontinence, Stress / Q000601:surgery
chemical_list: D005404:Fixatives; D005557:Formaldehyde
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