Female Urology A COMPARISON OF THE TRANSOBTURATOR AND RETROPUBIC MID- URETHRAL SLING PROCEDURES IN THE MANAGEMENT OF FEMALE STRESS URINARY INCONTINENCE

Introduction: We compared the outcomes of transobturator and retropubic mid-urethral sling procedures for female stress urinary incontinence (SUI) in the light of our experience and recent literature data. Materials and Methods: Between 2004 and 2007, 122 patients underwent mid-urethral sling surgery. Transobturator route was used in 68 patients [IVS04TM in 26, polypropylene mesh in 42 (TOT)] and retropubic procedures were performed in 54 patients [IVS02TM in 24, polypropylene mesh in 30 (TVT)]. Patients were compared for postoperative cure and incidences of various complications. Results: Cure was achieved in 86% and 87% of the patients after IVS04TM and IVS02TM, respectively. Likewise, 88% and 86% of the patients were cured following TOT and TVT procedure, respectively. Operation time was significantly shorter in transobturator procedures. Bladder injuries were seen in 2 cases with retropubic procedures while none occurred during transobturator surgeries. Urethral injury was evident in 1 patient during IVS02TTM procedure. Obstructive urinary symptoms were significantly higher following retropubic as compared to transobturator procedures. The incidence of vaginal erosion was not significantly different between either routes, however, the incidences were higher with the IVSTM tape. Urethral erosion, hematoma or wound infection was not observed. The incidences of de-novo urge symptoms were similar between retropubic and transobturator techniques. Conclusion: Transobturator techniques are as effective as retropubic techniques in the management of SUI with the advantages of shorter operation time and reduced risks of major adverse events.