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New surgical technique for treatment of stress urinary incontinence TVT-Obturator: new developments and results.
Surg Technol Int. 2005; 14:212-21.ST

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 complications. In our current series of more than 500 consecutive patients treated with TVT-O, no injury to the bladder or urethra was encountered and no perineal or obturator hematoma, heavy bleeding, or neurological complication was observed. Medium-term results have suggested that TVT-O is as efficient as retropubic tension-free slings for treatment of female SUI, with +/-90% complete cure rates after one-year follow up.

Authors+Show Affiliations

de Leval J
Department of Urology, University Hospital of Liège, Liège, Belgium.
Waltregny D
No affiliation info available

MeSH

FemaleHumansSurgical MeshTreatment OutcomeUrinary Incontinence, StressUrologic Surgical Procedures

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

16525975

Citation

de Leval, Jean, and David Waltregny. "New Surgical Technique for Treatment of Stress Urinary Incontinence TVT-Obturator: New Developments and Results." Surgical Technology International, vol. 14, 2005, pp. 212-21.
de Leval J, Waltregny D. New surgical technique for treatment of stress urinary incontinence TVT-Obturator: new developments and results. Surg Technol Int. 2005;14:212-21.
de Leval, J., & Waltregny, D. (2005). New surgical technique for treatment of stress urinary incontinence TVT-Obturator: new developments and results. Surgical Technology International, 14, 212-21.
de Leval J, Waltregny D. New Surgical Technique for Treatment of Stress Urinary Incontinence TVT-Obturator: New Developments and Results. Surg Technol Int. 2005;14:212-21. PubMed PMID: 16525975.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - New surgical technique for treatment of stress urinary incontinence TVT-Obturator: new developments and results. AU - de Leval,Jean, AU - Waltregny,David, PY - 2006/3/10/pubmed PY - 2006/6/17/medline PY - 2006/3/10/entrez SP - 212 EP - 21 JF - Surgical technology international JO - Surg Technol Int VL - 14 N2 - 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 complications. In our current series of more than 500 consecutive patients treated with TVT-O, no injury to the bladder or urethra was encountered and no perineal or obturator hematoma, heavy bleeding, or neurological complication was observed. Medium-term results have suggested that TVT-O is as efficient as retropubic tension-free slings for treatment of female SUI, with +/-90% complete cure rates after one-year follow up. SN - 1090-3941 UR - https://www.unboundmedicine.com/medline/citation/16525975/New_surgical_technique_for_treatment_of_stress_urinary_incontinence_TVT_Obturator:_new_developments_and_results_ DB - PRIME DP - Unbound Medicine ER -