title: 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 minimally invasive surgical procedure using the Trans- Obturator-Tape with "outside-in" approach for treatment female stress urinary incontinence.
  
  
  METHODS
  171 women with stress urinary incontinence (SUI) associated with urethral hypermobility, underwent the T.O.T. procedure (March 2010 to January 2014). 27 patients were previously operated for incontinence. Mean age was 59 years (37-80). 6 patients were having mixed incontinence, and 51 had SUI with urgencies. 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 22 months (4-45). At 12 months follow-up 91,2% of the patients were completely cured. The overall peri-operative complication rate was 6.4% with no vascular, nerve or bowel injury. 5 patients (2.9%) 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.forename: M
authors.initials: M
authors.lastname: Jovanović
authors.forename: Z
authors.initials: Z
authors.lastname: Džamić
authors.forename: M
authors.initials: M
authors.lastname: Aćimović
authors.forename: B
authors.initials: B
authors.lastname: Kajmaković
authors.forename: T
authors.initials: T
authors.lastname: Pejčić
mesh_terms: D005260:Female; D006801:Humans; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011126:Polypropylenes / Q000627:therapeutic use; D011183:Postoperative Complications / Q000628:therapy*; D053825:Suburethral Slings; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D016055:Urinary Retention / Q000209:etiology / Q000628:therapy; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods
chemical_list: D011126:Polypropylenes