title: Usage of a Trans-Obturator-Tape (T.O.T.) "outside-in" approach in surgical treatment of female stress urinary incontinence.
abstract: OBJECTIVE
  The aim of the study was to analyzed the efficacy and safety of a new minimally invasive surgical procedure using the Trans-Obturator-Tape with"outside-in" approach for treatment female stress urinary incontinence.
  
  
  METHODS
  31 women with stress urinary incontinence (SUI) associated with urethral hypermobility, underwent the T.O.T. procedure (March 2010 to January 2011). 5 patients were previously operated for incontinence. Mean age was 59 years (37-80). 10 patients were having mixed incontinence. A non-elastic, polypropylene tape was placed under the mid-urethra. The surgical placement technique utilises a trans-obturator percutaneous approach. All patients underwent post-operative clinical examination, cough-stress test (full bladder), uroflowmetry, and post-voiding residual assessment.
  
  
  RESULTS
  Mean follow-up was 5 months (1-9). At 6 months follow-up 96.7% of the patients were completely cured. The overall peri-operative complication rate was 6.4% with no vascular, nerve or bowel injury. One patients (3.4%) had post-operative urinary retention.
  
  
  CONCLUSIONS
  The present study confirms the results obtained by the instigator of the technique, E. Delorme, and allows us to consider T.O.T. as an effective and safe technique for the treatment of female stress urinary incontinence.
authors.affiliation: Clinic of Urology, School of Medicine, Clinical Center of Serbia, Belgrade.
authors.forename: Mirko
authors.initials: M
authors.lastname: Jovanovic
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Vuksanović
authors.forename: Zoran
authors.initials: Z
authors.lastname: Dzamić'
authors.forename: Miodrag
authors.initials: M
authors.lastname: Aćimović
authors.forename: Milan
authors.initials: M
authors.lastname: Radovanović
authors.forename: Ljubomir
authors.initials: L
authors.lastname: Djurasić
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D011126:Polypropylenes; D053825:Suburethral Slings; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*
chemical_list: D011126:Polypropylenes