Suburethral sling inserted by the transobturator route in the treatment of female stress urinary incontinence: preliminary results in 117 cases.

OBJECTIVE: Assessment of the transobturator out-in technique in the treatment of female urinary incontinence.

STUDY DESIGN: Obtape, a non-woven, 5% polypropylene tape was inserted via the transobturator route in patients suffering from stress or mixed urinary incontinence. From 1 February 2003 to 30 April 2004 117 patients have been operated. Mean age was 55 years (37-82). Follow-up range from 7 to 22 months (median follow-up time 16.3 months). All patients were assessed before surgery by clinical gynaecological examination and an urodynamic workup (post-void residual urine, flowmetry, voiding urgency thresholds and urethral profile).

RESULTS: There were no major complications and no deaths. There were six (5.1%) minor intraoperative problems and three (2.5%) tape erosions. The subjective level of complete and partial patient satisfaction was 92.3% (108 patients) and 4.2% (5 patients), respectively. Four patients (3.4%) felt that the situation was unchanged. No patients felt that their situation had deteriorated (Table 4). There is a concern in operating the subgroup of patients suffering from low MUPC with dysuria as the cure rate is very low.

CONCLUSIONS: Obtape transobturator tape is a safe, simple and rapid procedure for treating female stress urinary incontinence, avoiding the major risks of the retropubic approach. Evaluation of the results after a longer follow-up period is necessary to confirm the superiority of this technique.