Article (Scientific journals)
New surgical technique for treatment of stress urinary incontinence TVT-Obturator: New developments and results
de Leval, Jean; Waltregny, David
2005In Surgical Technology International, 14, p. 212-21
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Abstract :
[en] 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.
Disciplines :
Urology & nephrology
Author, co-author :
de Leval, Jean ;  Université de Liège - ULiège > Département des sciences cliniques > Urologie
Waltregny, David  ;  Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Labo de recherche sur les métastases
Language :
English
Title :
New surgical technique for treatment of stress urinary incontinence TVT-Obturator: New developments and results
Publication date :
2005
Journal title :
Surgical Technology International
ISSN :
1090-3941
Publisher :
Universal Medical Press, United States - California
Volume :
14
Pages :
212-21
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 25 January 2009

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