Journal of Minimally Invasive Gynecology
Virtual PosterComplications Following Outside-In and Inside-Out Transobturator-Tape Procedures With Concomitant Gynecologic Operations
Section snippets
Study Objective
This study was undertaken to compare the complications of outside-in transobturator tape procedures (TOT) and inside-out transobturator tape procedures (TVT-O) with concomitant gynecologic surgery for the treatment of female stress urinary incontinence (SUI).
Design
A retrospective review of 206 consecutive patients who underwent either TOT or TVT-O with concomitant gynecologic operations. The incidence of perioperative complications was compared.
Setting
An assessment of perioperative and postoperative complications
was made for each patient. Perioperative complications were recorded after surgery by the surgeon. Immediate and late postoperative complications were also recorded during the patient’s hospital stay and by the follow-up visit (after 1 month, 2 months, 1 year, and 2 to 3 years).
Patients
206 consecutive female patients diagnosed with SUI who underwent either the TVT-O (n=61) or TOT (n=145) procedure with a concomitant gynecologic operation were included. Diagnosis of SUI was based on typical subjective symptoms and on objective clinical data from the cough stress test, Q-tip test, or urodynamic studies.
Intervention
The Serasis (Serag Wiesner, Germany) tape was inserted through the outside-in route by using the technique recommended by Delorme in 2001. The inside-out procedure was performed as described by de Leval in 2003, and a tape (TVT-O, Gynecare, Johnson & Johnson, USA) was inserted.
Measurements and Main Results
There were no reports of intraoperative complications such as vaginal injury or bladder perforation. Postoperative complications were noted in 23 procedures (11.2%). These included 6 cases of urinary retention (2.9%), 2 cases of vulva hematoma (1.0%), 7 cases of urinary tract infection (3.4%), 4 cases of de novo urgency (2.9%), and 4 cases of vaginal erosion (2.9%). There were no significant differences in complication rates between the two groups.
Conclusion
Our results suggest that inside-out and outside-in procedures are simple and safe techniques that may have a low rate of complications when used with a concomitant gynecologic operation.