ABSTRACT
Objective of this study was to assess the effectiveness of Transobturator tension free vaginal tape [TOT] for the treatment of the genuine stress incontinence by using improvised instruments i.e. specific needles, which is far economical than the patent company made TOT set. Prospective cohort study Place and Duration of Study: This study was carried out in Armed Forces Institute of Urology [AFIU] Rawalpindi from Jan 2007 to Jun 2009 Thirty eight patients were included in study and were operated upon in two and half years. Polypropylene mesh was used transvaginally as mid urethral sling through the obturator foramen 'outside in' technique using special needles. All the patients who only had genuine stress incontinence. Were included. Results:: A total of 31 [81.57%] of the patients had total satisfaction post operatively. Four [10.52%] patients had equivocal results but improved and had incontinence only when there was strenuous and tough strain. Only 1 [2.63%] patient had no effects on the disease. Two [5.26%] patient had retention of the urine postoperatively for which Foley catheter had to pass for maximum of 18 days. Three [7.89%] patients had minor infection at exit sites of wound and were treated with the oral antibiotics. Genuine stress incontinence [GSI] is quite common problem in our females especially who had multiple deliveries .TOT is simple, effective and very economical solution to have the best results in our setup. Patients selection, detailed history physical and pelvic examination are most important factors to have the required results