PMID: 16525975Mar 10, 2006Paper

New surgical technique for treatment of stress urinary incontinence TVT-Obturator: new developments and results

Surgical Technology International
Jean de Leval, David Waltregny

Abstract

A new surgical technique, the inside-out transobturator tension-free urethral suspension (TVT-Obturator), has been developed for treatment of women suffering from stress urinary incontinence (SUI). This simple procedure uses specifically designed surgical instruments to allow the accurate passage of a synthetic tape from underneath the urethra, through the obturator foramens, toward the thigh folds, with the tape being positioned without tension under the junction between mid and distal urethra. Cadaver dissection studies have demonstrated that the anatomical trajectory of the tape in tissues is strictly perineal and consistently coursed away from neighboring neurovascular structures, including the obturator, femoral, and saphenous nerves and vessels, as well as the pudendal nerve. Consequently, as opposed to retropubic sling systems, no perioperative cystoscopy is required because the TVT-O tape does not enter the pelvic region at any time during the procedure. These anatomical data, which suggest the TVT-O technique is safe, have been corroborated by initial clinical experience. Our feasibility and ongoing efficacy studies have shown that TVT-O is associated with a low incidence of perioperative and postoperative complication...Continue Reading

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