[Anatomic characteristics of transobturative approach in application of a tension-free tape for treatment of women with stress urinary incontinence].

We studied safety and topographic characteristics of a transobturative approach in application of an "inside out" tension free tape (TFT) for management of stress urinary incontinence (SUI) in women. The anatomic sections were made on 6 fresh female cadavers (mean age of the deceased 78.5 +/- 4 years). After the tape placement a femoral section was made with its extension to the perineum and retropelvic section. We found that the TFT passes far from the major femoral structures. The distance from the obturator canal to the TFT averaged 24.4 mm +/- 1.8 mm (from 23.9 to 30.4 mm, median 21.4 mm). Dissection of the dorsal nerve and artery of the clitoris as well as the pudendal nerve showed that these structures are not damaged in correct operative technique. Moreover, the tape passes beneath the pelvic fascia and levators, it does not penetrate the pelvic cavity. Thus, the transobturative approach is safe, does not damage vital organs and anatomic structures in the treatment of women with SUI.