Preliminary Report on a Modified Surgical Technique Using Canal Transobturator Tape for the Treatment of Female Stress Urinary Incontinence

Abstract

Purpose: Canal transobturator tape (TOT) was developed to reduce the complications of TOT by modifying the sling procedure of TOT with using a distal urethral polypropylene sling (DUPS). The aim of this present study was to describe a modified surgical technique for the treatment of female urodynamic stress urinary incontinence and to assess the objective and subjective efficacy of Canal TOT. Materials and Methods: Between October 2006 and November 2007, 87 female patients with stress urinary incontinence were enrolled in this retrospective study. All the patients underwent the Canal TOT procedure. The Incontinence Impact Questionnaire-7 (IIQ-7) and the Urogenital Distress Inventory-6 (UDI-6) were used to evaluate the surgical outcomes. Results: The mean operative time for Canal TOT was 22.4 minutes (range: 15-39). During the surgery, there were 10% intraoperative and postopreative complications, including De novo urgency (n=3), weak stream (n=4) and difficult emptying (n=2). Yet all these complications occurred in the short-term and they were transient. Concomitant procedures were performed, including cystocele repair (n=7), rectocele repair (n=5), rectocele and cystocele repair (n=14), laparoscopically-assisted vaginal hysterectomy (n=5) and total vaginal hysterectomy (n=1). The average follow-up was 4.5 months (range: 3-12). Both the mean IIQ-7 and UDI-6 scores significantly decreased after Canal TOT and all the patients showed significant improvement of their subjective symptoms of stress incontinence. Conclusions: Our results demonstrate that Canal TOT may be a safe and effective surgical method for treating urodynamic stress incontinence in Korean women and this procedure provides a high cure rate. (Korean J Urol 2008;49:1119-1124) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏