title: TOT 8/4: A Way to Standardize the Surgical Procedure of a Transobturator Tape.
abstract: Suburethral tapes are placed "tension-free" below the urethra. Several studies reported considerable differences of the distance between urethra and tape. These distances ranged from 1 to 10 mm amongst different patients. This either caused urethral obstruction or had no effect on urinary incontinence. Therefore, we decided to standardize the procedure by placing a Hegar dilator of 8-millimeter diameter in the urethra and another Hegar dilator of 4-millimeter diameter between the urethra and the tape during transobturator tape placement. Using that simple technique, which we named "TOT 8/4," we observed that 83% of the tapes were placed in the desired distance between 3 and 5 millimeters below the urethra.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Urogynecology and Pelvic Floor Surgery, University of Cologne, Kerpener Strasse 34, 50931 Cologne, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Ludwig
authors.affiliation: Department of Obstetrics and Gynecology, Division of Urogynecology and Pelvic Floor Surgery, University of Cologne, Kerpener Strasse 34, 50931 Cologne, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Stumm
authors.affiliation: Department of Obstetrics and Gynecology, Division of Urogynecology and Pelvic Floor Surgery, University of Cologne, Kerpener Strasse 34, 50931 Cologne, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Mallmann
authors.affiliation: Department of Obstetrics and Gynecology, Division of Urogynecology and Pelvic Floor Surgery, University of Cologne, Kerpener Strasse 34, 50931 Cologne, Germany.
authors.forename: Wolfram
authors.initials: W
authors.lastname: Jager
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D053825:Suburethral Slings / Q000592:standards*; D013526:Surgical Mesh / Q000592:standards*; D014521:Urethra / Q000473:pathology / Q000601:surgery*; D014549:Urinary Incontinence / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*