Transvaginal obturator tape (TOT) to treat female stress urinary incontinence
Keywords:
URINARY STRESS INCONTINENCE, UROLOGICAL SURGICAL PROCEDURES
Abstract
The use of a suburethral sling via a trans-obturator percutaneous route is a new approach to treat female stress urinary incontinence.
Needles were used to set a suburethral sling made of polypropylene.
The study includes seventy women who underwent surgery from October 2002 to December 2003. In 34 cases, only Transvaginal Obturator Tape (TOT) was performed, while in 36 TOT was performed within another surgery.
At 21.4 months average of follow-up, cure rates (dry patient without protection) were reached by 64 cases (91,4%), recurrent incontinence was seen in 4 cases (5,7%) while improvement without total cure was determined in 2 cases (2,8%).
Mean surgery duration of TOT was 19,5 minutes.
Post-surgical hospital stay was 34 hours for TOT procedures.
No vesicle, urethral or other visceral injuries were reported. Only one case of bleeding over 100 ml was reported.
Medium term results were very satisfactory.
Surgical technique is standard, safe and can be reproduced. The technique might be combined to other corrective surgeries of the pelvis. Surgical costs are very convenient.
References
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2) DeLancey JO. Structural support of the urethra as it relates to stress urinary incontinence: the hammock hypothesis. Am J Obstet Gynecol 1994; 170(6): 1713-20; discussion 1720-3.
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8) Hermieu J. Complications of the TVT technique. Prog Urol 2003; 13(3): 459-65.
9) Riedler I, Primus G, Trummer H, Maier A, Rauchenwald M, Hubmer G. Fournier’s gangrene after tension-free vaginal tape (TVT) procedure. Int Urogynecol J Pelvic Floor Dysfunct 2004; 15(2): 145-6.
10) Jeffry L, Deval B, Birsan A, Soriano D, Darai E. Objetive and subjetive cure rates after tension-free vaginal tape for tratement of urinary incontinence. Urology 2001; 58(5): 702-6.
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12) Frankel G. Re: Complication of bowel perforation during insertion of tension-free vaginal tape. J Urol 2004; 171(5): 1888.
13) Morgan TO Jr, Westney OL, McGuire EJ. Pubovaginal sling: 4 years outcome analysis and quality of life assessment. J Urol 2000; 163(6): 1845-8.
14) Wang A, Chen MC. Randomized comparison of local versus epidural anesthesia for tension-free vaginal tape operation. J Urol 2001; 165(4): 1177-80.
15) Chassagne S, Bernier PA, Haab F, Roehrborn CG, Reisch JS, Zimmern PE. Proposed cutoff values to define bladder outlet obstruction in women. Urology 1998; 51(3): 408-11.
16) Tsivian A, Kessler O, Mogutin B, Rosenthal J, Korczak D, Levin S, et al. Tape related complications of the tension-free vaginal tape procedure. J Urol 2004; 171(2 Pt 1): 762-4.
17) Delorme E. Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women. Prog Urol 2001; 11(6): 1306-13.
18) Dargent D, Bretones S, George P, Mellier G. Insertion of a sub-urethral sling through the obturating membrane for treatment of female urinary incontinence. Gynecol Obstet Fertil 2002; 30(7-8): 576-82.
19) de-Leval J. Novel surgical technique for the treatment of female stress urinary incontinence: transobturator vaginal tape inside-out. Eur Urol 2003; 44(6): 724-30.
20) Regules E. Anatomía de la región obturatriz. Su valor en la cirugía de la incontinencia de orina. Jornada de la Asociación Argentino Uruguaya de Anatomía, 2. Corrientes (Argentina), 2003.
21) Mellier G, Benayed B, Bretones S, Pasquier JC. Suburethral tape via the obturator route: is the TOT a simplification of the TVT? Int Urogynecol J Pelvic Floor Dysfunct 2004; 15(4): 227-32.
22) deTayrac R, Deffieux X, Droupy S, Chauveaud-Lambling A, Calvanese-Benamour L, Fernández H. A prospective randomized trial comparing tension-free vaginal tape and transobturator suburethral tape for surgical treatment of stress urinary incontinence. Am J Obstet Gynecol 2004; 190(3): 602-8.
23) Hermieu JF, Milcent S. Synthetic suburethral sling in the treatment of stress urinary incontinence in women. Prog Urol 2003; 13(4): 636-47.
24) Lukacz ES, Luber KM, Nager CW. The effects of the tension-free vaginal tape on proximal urethral position: a prospective, longitudinal evaluation. Int Urogynecol J Pelvic Floor Dysfunct 2003; 14(3): 179-84; discussion 184.
25) Leach GE, Dmochowski RR, Appell RA, Blaivas JG, Hadley HR, Luber KM, et al. Female Stress Urinary Incontinence Clinical Guidelines Panel summary report on surgical management of female stress urinary incontinence. The American Urological Association. J Urol 1997; 158(3 Pt 1): 875-80.
2) DeLancey JO. Structural support of the urethra as it relates to stress urinary incontinence: the hammock hypothesis. Am J Obstet Gynecol 1994; 170(6): 1713-20; discussion 1720-3.
3) Delancey JO. Fascial and muscular abnormalities in women with urethral hypermobility and anterior vaginal wall prolapse. Am J Obstet Gynecol 2002; 187(1): 93-8.
4) Ulstem U, Petros P. Intravaginal slingplasty (IVS): an ambulatory surgical procedure for treatment of female urinary incontinence. Scand J Urol Nephrol 1995; 29(1): 75-82.
5) Boublil V, Ciofu C, Traxer O, Sebe P, Haab F. Complications of urethral sling procedures. Curr Opin Obstet Gynecol 2002; 14(5): 515- 20.
6) Vierhout ME. Severe hemorrhage complicating tension-free vaginal tape (TVT): a case report. Int Urogynecol J Pelvic Floor Dysfunct 2001; 12(2): 139-40.
7) Zilbert AW, Farrell SA. External iliac artery laceration during tension-free vaginal tape procedure. Int Urogynecol J Pelvic Floor Dysfunct 2001; 12(2): 141-3.
8) Hermieu J. Complications of the TVT technique. Prog Urol 2003; 13(3): 459-65.
9) Riedler I, Primus G, Trummer H, Maier A, Rauchenwald M, Hubmer G. Fournier’s gangrene after tension-free vaginal tape (TVT) procedure. Int Urogynecol J Pelvic Floor Dysfunct 2004; 15(2): 145-6.
10) Jeffry L, Deval B, Birsan A, Soriano D, Darai E. Objetive and subjetive cure rates after tension-free vaginal tape for tratement of urinary incontinence. Urology 2001; 58(5): 702-6.
11) Haab F, Traxer O, Ciofu C. Tension free vaginal tape: why unusual concept is so successful. Curr Opin Urol 2001; 11(3): 293-7.
12) Frankel G. Re: Complication of bowel perforation during insertion of tension-free vaginal tape. J Urol 2004; 171(5): 1888.
13) Morgan TO Jr, Westney OL, McGuire EJ. Pubovaginal sling: 4 years outcome analysis and quality of life assessment. J Urol 2000; 163(6): 1845-8.
14) Wang A, Chen MC. Randomized comparison of local versus epidural anesthesia for tension-free vaginal tape operation. J Urol 2001; 165(4): 1177-80.
15) Chassagne S, Bernier PA, Haab F, Roehrborn CG, Reisch JS, Zimmern PE. Proposed cutoff values to define bladder outlet obstruction in women. Urology 1998; 51(3): 408-11.
16) Tsivian A, Kessler O, Mogutin B, Rosenthal J, Korczak D, Levin S, et al. Tape related complications of the tension-free vaginal tape procedure. J Urol 2004; 171(2 Pt 1): 762-4.
17) Delorme E. Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women. Prog Urol 2001; 11(6): 1306-13.
18) Dargent D, Bretones S, George P, Mellier G. Insertion of a sub-urethral sling through the obturating membrane for treatment of female urinary incontinence. Gynecol Obstet Fertil 2002; 30(7-8): 576-82.
19) de-Leval J. Novel surgical technique for the treatment of female stress urinary incontinence: transobturator vaginal tape inside-out. Eur Urol 2003; 44(6): 724-30.
20) Regules E. Anatomía de la región obturatriz. Su valor en la cirugía de la incontinencia de orina. Jornada de la Asociación Argentino Uruguaya de Anatomía, 2. Corrientes (Argentina), 2003.
21) Mellier G, Benayed B, Bretones S, Pasquier JC. Suburethral tape via the obturator route: is the TOT a simplification of the TVT? Int Urogynecol J Pelvic Floor Dysfunct 2004; 15(4): 227-32.
22) deTayrac R, Deffieux X, Droupy S, Chauveaud-Lambling A, Calvanese-Benamour L, Fernández H. A prospective randomized trial comparing tension-free vaginal tape and transobturator suburethral tape for surgical treatment of stress urinary incontinence. Am J Obstet Gynecol 2004; 190(3): 602-8.
23) Hermieu JF, Milcent S. Synthetic suburethral sling in the treatment of stress urinary incontinence in women. Prog Urol 2003; 13(4): 636-47.
24) Lukacz ES, Luber KM, Nager CW. The effects of the tension-free vaginal tape on proximal urethral position: a prospective, longitudinal evaluation. Int Urogynecol J Pelvic Floor Dysfunct 2003; 14(3): 179-84; discussion 184.
25) Leach GE, Dmochowski RR, Appell RA, Blaivas JG, Hadley HR, Luber KM, et al. Female Stress Urinary Incontinence Clinical Guidelines Panel summary report on surgical management of female stress urinary incontinence. The American Urological Association. J Urol 1997; 158(3 Pt 1): 875-80.
Published
2005-06-30
How to Cite
1.
Briozzo L, Vidiella G, Curbelo F, Craviotto F, Massena B, Varela López R, Martínez A, Rodríguez F. Transvaginal obturator tape (TOT) to treat female stress urinary incontinence. Rev. Méd. Urug. [Internet]. 2005Jun.30 [cited 2024May17];21(2):130-4. Available from: http://www2.rmu.org.uy/ojsrmu311/index.php/rmu/article/view/816
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