Outside-in TOT Procedure: Three-Years Experience with 175 Cases

INTRODUCTION: The aim of this study is to evaluate the surgical outcomes and complications of transobturator tape (TOT) procedure.
METHODS: In this study, 175 patients who were undergone TOT procedure due to pure stress urinary incontinence (SUI) or mixt urinary incontinence
(MUI) from 2011-2014 and examined at 1st and 3rd postoperative months with physical examination and stress tests were evaluated retrospectively.
RESULTS: All of the patients were multiparous and the median age was 50.0±11.3 years. Sixty-eight (38.8%) of the patients were postmenopausal and sixty-two (35%) of the patients who had TOT operation had extra surgery. One patient is complicated
with bladder perforation. Only one patient had blood transfusion requirement due to TOT operation. Intraoperative bleeding more than 200 ml. is seen in 6 patients. Four patients had vaginal fornix perforation. Three patients had developed perineal pain.
De-novo urge incontinence was seen in 8 patients in the postoperative period and was successfully treated with anticholinergic drugs. Mesh removals and reconstruction of vaginal mucosa were done for 6 patients who had vaginal erosions. The objective and subjective cure rates were found to be 87.4% and 82.8%, respectively.
DISCUSSION AND CONCLUSION: The use of mid-urethral synthetic slingis the first-choice of the surgical treatment of SUI nowadays. The main reasons for this are low complication rates due to surgical technique, the use of good quality materials, short operation time, and short hospital stay.