Transobturator Tape (TOT) for treatment of female stress incontinence : early experience

ABSTRACT

Objective Evaluation of the transobturator tape (TOT); the newest tension-free technique for the treatment of female stress urinary incontinence (SUI) and its early results with 6 months follow up. Patients and Methods This study was conducted at King Saud Hospital; Saudi Arabia; between September 2002 and March 2004. Fourteen cases with pure SUI were treated with Uratape; a low- elasticity polypropylene tape; according to the technique described by Delorme1;2. Preoperative assessment included full history; urogynecological examination; cough stress test; Q-tip test; cystogram and urodynamic studies. Perioperative cystoscopy was also done. Results No intraoperative complications were recorded. Postoperative complications included transient incisional pain in 2 (14.3); transient voiding difficulty in 5 (35.7) and urgency and frequency withmild pyuria in 3 cases (21.4). Mild groin ecchymosis was seen in 5 cases (35.7). Vaginal wound infection and wound dehiscence with subsequent tape removal occurred in one case only (7.1) Twelve cases (85.7) achieved full continence and one patient (7.1) had minimal leak with extreme stress but was fully satisfied. Conclusion From the promising results of our early experience we conclude that the TOT procedure is a simple; safe; fast and minimally invasive technique for the treatment of SUI in women with few minor complications and a high success rate. Further studies on a larger number of patients will however be needed to confirm these results: