Obturator approach in the surgical treatment of stress urinary incontinence using tension-free transvaginal tape.

The study reviews the surgical treatment results of urinary stress incontinence in the group of 51 female patients, in whom the tension-free transvaginal tape was placed beneath the middle part of urethra using obturator approach during the period from 2005 to 2009. The method of surgery applied in all patients was obturator approach ("inside-out" method sec. de Leval), using a synthetic tension-free transvaginal prolen tape. After the sub-urethral tunnel had been created by scissors, the obturator membrane was perforated, then the placement of wing guides followed, through which helical needles with synthetic tape were brought to the skin. The following complications were observed in 8 (15.7%) patients: erosion of tape in 2 (3.9%), urine retention in 2 (3.9%), bleeding from the site of incision in 1 (1.9%) and transitory leg pain in 3 (5.8%) cases. Two years after the surgery, 43 (84.3%) patients were dry, 4 (7.8%) patients showed a significant improvement, while the recurrence was recorded in 4 (7.8%) operated patients.