Surgical treatment of stress urinary incontinence by suburethral transobturator tape

Objective. - Assessment of the suburethral transobturator tape in the treatment of female urinary stress incontinence. Patients and methods. - Retrospective evaluation of 39 slings. Three patients (7%) were lost to follow-up. Analysis was carried on 19 out/in procedures (mainly ObTape (R) and Uratape (R) slings) and 17 in/out procedures (TVT-O (R), slings). Nine patients (25%) had a history of previous stress incontinence surgery. In 21 cases (58%) there was a concomitant surgical procedure, including genital prolapse repair (12) and total hysterectomy (6). Phone interviews were conducted with the validated questionnaires MHU and Ditrovie (R) short form. Results. - The mean operative time was 17 minutes (10-30). Three vaginal wounds (8%) were immediately repaired. Two urinary retentions (5%) were managed by suprapubic catheterization for more than 10 days. With a mean follow-up of 12 months (4-23) the subjective effectiveness on stress incontinence was 89% (cure: 5 8%; improvement: 31%). Urge incontinence symptoms were cured in 47% of mixed incontinences. Two patients reported an important dysuria. Two sling exposures occurred. Quality of life scores were significantly improved (mean 1,7 versus 3,2, p = 0,002). The level of satisfaction reached 89% (very satisfied: 50%; satisfied: 39%). Discussion and conclusion. - This technique is safe and effective. Our results are nevertheless inferior to those previously reported. Prospective randomised studies comparing the two surgical routes are required. (C) 2007 Elsevier Masson SAS. Tous droits reserves.