Anatomical premises for the variability of the results of transobturator mid-urethral sling

Introduction . The implantation of a synthetic sub-urethral sling is the main method surgical correction stress urinary incontinence (SUI). However, investigation results long-term effectiveness indicate ambiguity surgery outcomes. In addition, problem pain in perineum remains relevant for everyday practice. One important aspects this matter may be variant technique installing suburethral sling, including based on anatomical variability small pelvis. Purpose study To identify key factors that can negatively affect and safety environment women. Materials methods consisted 2 parts - clinical. part study, was implanted 20 preparations female pelvis with lower limb preserved soft tissues. clinical involved 50 patients incontinence. These underwent installation transobturator two ways using “inside-out” technique: standard “external landmarks” proposed developed first study. After visualization original method, outcomes operations were assessed depending location patient's Results most atraumatic determined by rotating tool around branch pubic bone. demonstrated higher efficiency operation at follow-up 1 year, presumably due to U-shaped angle «hammock» urethra, which characteristic retropubic sling. Conclusion Outcomes SUI depend, among other things, implantation.