Objective: The aim of our study was to retrospectively analyze surgical complications arising from the collocation of suburethral mesh in the lower urinary tract, using both the transobturator and retropubic methods. Patients and Methods: During the period between November 2002 and June 2011, we retrospectively studied 190 patients that were treated for stress urinary incontinence using a tension-free suburethral sling. 50 patients were treated using the retropubic route (SPARC®), and 140 patients were treated using a transobturator (MONARC®). Results: In total, 16.57% of the patients presented with intraoperative, immediate postoperative or later postoperative complications. We observed a higher rate of complications with patients who were operated on retropubically (26%) than with patients who were operated on using the transobturator method (12%). Conclusions: The rate of complications for our study was low, and was even lower in the case of transobturator tape. Thus, we usually used transobturator tape in the treatment of stress incontinence.

Keywords:
Stress urinary incontinence, Tension-free suburethral sling, Retropubic method, Transobturator method, Complications
1.
Jiménez Calvo J, Hualde Alfaro A, De Pablo Cárdenas A, Cebrian Lostal JL, Álvarez Bandres S, Raigoso Ortega O: TOT en el tratamiento de la incontinencia de esfuerzo: nuestra experiencia, comparándola con la TVT. Actas Urol Esp 2007;31:1134–1140.
2.
Sanz Pérez G, Rodríguez-Rubio Cortadellas FI, Garrido Insua S, et al: TVT para la incontinencia urinaria femenina: estudio multicéntrico español. Actas Urol Esp 2005;29:632–640.
3.
Porena M, Constantini E, Frea B, et al: Tension-free vaginal tape versus transobturator tape as surgery for stress urinary incontinence: results of a multicentre randomised trial. Eur Urol 2007;52:1481–1491.
4.
Torres Zambrano G, Luján Galán M, Martín García C, García Tello A, Rodríguez García N, Berenguer Sánchez A: TVT y TOT para la corrección quirúrgica de la incontinencia femenina de stress. Comparación de ambas técnicas. Arch Esp Urol 2008;61:861–865.
5.
Latthe PM, Foon R, Toozs-Hobson P: Transobturator and retropubic tape procedures in stress urinary incontinence: a systematic review and meta-analysis of effectiveness and complications. BJOG 2007;114:522–531.
6.
Ponce Díaz-Reixa J, Barbagelata López A, Álvarez Castelo L, et al: Tratamiento quirúrgico de la incontinencia urinaria de esfuerzo mediante cabestrillo suburetral SPARC. Análisis de nuestra experiencia. Actas Urol Esp 2007;31:1129–1133.
7.
Solá Dalenz V, Pardo Schanz J, Ricci Arriola P, Guiloff Fische E, Chiang Miranda H: Cirugía mínimamente invasiva en la incontinencia urinaria femenina: TVT-O. Actas Urol Esp 2006;30:61–66.
8.
Roumeguére T, Quackels TH, Bollens R, et al: Trans-obturator vaginal tape (TOT) for female stress incontinence: one year follow-up in 120 patients. Eur Urol 2005;48:805–809.
9.
Purnichescu V, Cheret-Benoist A, Eboué C, Von Theobald P: Surgical treatment for female stress urinary incontinence by transobturator tape (outside in). Study of 70 cases. J Gynecol Obstet Biol Reprod (Paris) 2007;36:451–458.
10.
Cañís Sánchez D, Bielsa Galí Ó, Cortadellas Ángel R, Arango Toro O, Placer Santos J, Gelabert-Mas A: Resultados y complicaciones de la técnica TVT en el tratamiento de la incontinencia de esfuerzo femenina. Actas Urol Esp 2005;29:287–291.
11.
George S, Begum R, Thomas-Philip A, Thirumalakumar L, Sorinola O: Two-year comparison of tension-free vaginal tape and transobturator tape for female urinary stress incontinence. J Obstet Gynaecol 2010;30:281–284.
12.
Long CY, Hsu CS, Wu MP, Liu CM, Wang TN, Tsai EM: Comparison of tension-free vaginal tape and transobturator tape procedure for the treatment of stress urinary incontinence. Curr Opin Obstet Gynecol 2009;21:342–347.
13.
Quicios Dorado C, Fernández Fernández E, Gómez García I, Perales Cabanas L, Arias Fúnez F, Escudero Barrilero A: Tratamiento de la incontinencia urinaria de esfuerzo con el sistema TVT: Complicaciones en nuestros primeros 100 casos. Actas Urol Esp 2005;29:750–756.
14.
Kaelin-Gambirasio I, Jacob S, Boulvain M, Dubuisson JB, Dällenbach P: Complications associated with transobturator sling procedures: analysis of 233 consecutive cases with a 27-month follow-up. BMC Womens Health 2009;9:28–34.
15.
Tahseen S, Reid PC, Charan P: Short-term complications of the trans-obturator foramen procedure for urinary stress incontinence. J Obstet Gynaecol 2007;27:500–502.
16.
Zugor V, Labanaris AP, Rezaei-Jafari MR, et al: TVT vs. TOT: a comparison in terms of continence results, complications and quality of life after a median follow-up of 48 months. Int Urol Nephrol 2010;42:915–920.
17.
Latthe PM: Review of transobturator and retropubic tape procedures for stress urinary incontinence. Curr Opin Obstet Gynecol 2008;20:331–336.
18.
Nissar Khan F, Hamid A, Singh Wazir B, Saleem Wani M, Ahmad Z: An evaluation of use of trans-obturator tape (TOT) sling procedure in the current surgical management of female stress urinary incontinence. Int J Health Sci 2008;2:118–125.
19.
Gilberti C, Gallo F, Cortese P, Schenone M: Transobturator tape for treatment of female stress urinary incontinence: objective and subjective results after a mean follow-up of two years. Urology 2007;69:703–707.
20.
Chawla A: Transobturator tapes are preferable over transvaginal tapes for the management of female stress urinary incontinence: against. Indian J Urol 2009;25:554–557.
© 2012 S. Karger AG, Basel
2012
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.