Recent data on the tension-free transobturator tape procedure for the treatment of female stress urinary incontinence are reviewed.
Although long-term data are not available, the effectiveness and safety of the tension-free transobturator tape procedure as reported during the past 5 years are very promising and this procedure is becoming a popular surgical treatment for female stress urinary incontinence. The continence rates obtained have been similar to those obtained using the retropubic tension-free vaginal tape on short-term follow-up. Clinical data as well as studies on cadaveric dissections suggest that complication rates can be decreased significantly with the transobturator approach. In the original tension-free transobturator tape procedure, the tape is inserted through the obturator foramen from the outside-to-inside direction (skin incision to vaginal incision). The inside-to-outside approach with passage of the tape from the vaginal incision to the obturator foramen has also been described.
The tension-free transobturator tape procedure provides a useful alternative to the retropubic tension-free vaginal tape approach while maintaining the principles of tension-free midurethral support. By avoiding the intrapelvic and retropubic passage, complications can be decreased. The effectiveness of this approach is similar to that of tension-free vaginal tape on short-term follow-up.
Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Harbor – UCLA Medical Center, David Geffen School of Medicine, University of California, Los Angeles, California, USA
Correspondence to Mat H. Ho, MD, PhD, Division of Female Pelvic Medicine and Reconstructive Surgery, Harbor – UCLA Medical Center, David Geffen School of Medicine, University of California at Los Angeles, 1000 W Carson St, Box 489, Torrance, CA 90509-2910, USA Tel: +310 222 3868; fax: +310 222 4149; e-mail: email@example.com