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Modified transobturator tape (canal transobturator tape) surgery for female stress urinary incontinence.
J Urol. 2009 Jun; 181(6):2616-21.JU

Abstract

PURPOSE

To mitigate TOT complications we designed a modified TOT technique called canal TOT. We describe this new technique and evaluate its feasibility.

MATERIALS AND METHODS

Between October 2006 and June 2007, 105 consecutive women with stress urinary incontinence underwent a canal TOT procedure. Two oblique lateral incisions were made in the anterior vaginal wall and a suburethral canal was created between the incisions. Mesh was transferred beneath the canal. The subsequent canal TOT surgical steps were identical to those of the original TOT procedure. All patients were evaluated by urological examination and self-assessment questionnaires (Incontinence Impact Questionnaire-Short Form and Urogenital Distress Inventory-Short Form) preoperatively and 12 months postoperatively. Reportedly dyspareunia developed after the operation.

RESULTS

A minimum 1-year followup was available in 99 patients. Median operative time was 25 minutes (range 15 to 50). No mesh erosion, retropubic hematoma or complete bladder retention developed. Transient postoperative voiding dysfunction and transient de novo urgency were observed in 2 (2.0%) and 8 patients (8.1%), respectively. Dyspareunia developed after surgery in 4 patients (4.0%). Postoperatively Incontinence Impact Questionnaire-Short Form and Urogenital Distress Inventory-Short Form scores decreased significantly (p <0.05). Objective and subjective cure rates were 98.0% and 89.9%, respectively.

CONCLUSIONS

The canal TOT procedure is feasible and effective for mitigating the complications of the original TOT procedure. This technique might be especially useful in patients with cystocele because of the paravaginal defect as well as in patients with obesity or prior vaginal surgery. However, a large-scale and long-term followup study is required to verify the effectiveness of this technique.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19375104

Citation

Lee, Jung Hun, et al. "Modified Transobturator Tape (canal Transobturator Tape) Surgery for Female Stress Urinary Incontinence." The Journal of Urology, vol. 181, no. 6, 2009, pp. 2616-21.
Lee JH, Yoon HJ, Lee SJ, et al. Modified transobturator tape (canal transobturator tape) surgery for female stress urinary incontinence. J Urol. 2009;181(6):2616-21.
Lee, J. H., Yoon, H. J., Lee, S. J., Kim, K. H., Choi, J. S., & Lee, K. W. (2009). Modified transobturator tape (canal transobturator tape) surgery for female stress urinary incontinence. The Journal of Urology, 181(6), 2616-21. https://doi.org/10.1016/j.juro.2009.02.033
Lee JH, et al. Modified Transobturator Tape (canal Transobturator Tape) Surgery for Female Stress Urinary Incontinence. J Urol. 2009;181(6):2616-21. PubMed PMID: 19375104.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Modified transobturator tape (canal transobturator tape) surgery for female stress urinary incontinence. AU - Lee,Jung Hun, AU - Yoon,Hyo Jin, AU - Lee,Su Jin, AU - Kim,Kye Hyun, AU - Choi,Joong Sub, AU - Lee,Kyo Won, Y1 - 2009/04/16/ PY - 2008/11/05/received PY - 2009/4/21/entrez PY - 2009/4/21/pubmed PY - 2009/6/23/medline SP - 2616 EP - 21 JF - The Journal of urology JO - J Urol VL - 181 IS - 6 N2 - PURPOSE: To mitigate TOT complications we designed a modified TOT technique called canal TOT. We describe this new technique and evaluate its feasibility. MATERIALS AND METHODS: Between October 2006 and June 2007, 105 consecutive women with stress urinary incontinence underwent a canal TOT procedure. Two oblique lateral incisions were made in the anterior vaginal wall and a suburethral canal was created between the incisions. Mesh was transferred beneath the canal. The subsequent canal TOT surgical steps were identical to those of the original TOT procedure. All patients were evaluated by urological examination and self-assessment questionnaires (Incontinence Impact Questionnaire-Short Form and Urogenital Distress Inventory-Short Form) preoperatively and 12 months postoperatively. Reportedly dyspareunia developed after the operation. RESULTS: A minimum 1-year followup was available in 99 patients. Median operative time was 25 minutes (range 15 to 50). No mesh erosion, retropubic hematoma or complete bladder retention developed. Transient postoperative voiding dysfunction and transient de novo urgency were observed in 2 (2.0%) and 8 patients (8.1%), respectively. Dyspareunia developed after surgery in 4 patients (4.0%). Postoperatively Incontinence Impact Questionnaire-Short Form and Urogenital Distress Inventory-Short Form scores decreased significantly (p <0.05). Objective and subjective cure rates were 98.0% and 89.9%, respectively. CONCLUSIONS: The canal TOT procedure is feasible and effective for mitigating the complications of the original TOT procedure. This technique might be especially useful in patients with cystocele because of the paravaginal defect as well as in patients with obesity or prior vaginal surgery. However, a large-scale and long-term followup study is required to verify the effectiveness of this technique. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/19375104/Modified_transobturator_tape__canal_transobturator_tape__surgery_for_female_stress_urinary_incontinence_ L2 - https://www.jurology.com/doi/10.1016/j.juro.2009.02.033?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -