Transobturator mid urethral sling surgery for stress urinary incontinence: our experience


  • Ramesh Bettaiah Department of Obstetrics and Gynecology, Dr Ramesh Hospital, Bangalore, India
  • Reshu Saraogi Department of Obstetrics and Gynecology, Dr Ramesh Hospital, Bangalore, India
  • Chandana A. Reddy Department of Obstetrics and Gynecology, Dr Ramesh Hospital, Bangalore, India



Stress urinary continence, Minimally invasive surgery, Transobturator tape, Prognosis, Complications


Background: We retrospectively evaluated the cure & improvement rate and complications incidence following transobturator approach of mid urethral sling surgery (MUS) for stress urinary incontinence (SUI).

Methods: Of the total 52 patients who underwent transobturator approach of midurethral sling surgery for stress urinary incontinence at Dr. Ramesh Hospital, Bangalore, India, between January 2006 – December 2009, 48 women were available for clinical follow-up investigation. At follow-up, all 48 patients underwent a cough test, a pad test, and sonographic postvoid residual volume measurement. Women rated their subjective continence status (continent, slightly incontinent, incontinent). Objective cure was defined as a pad weight 0–1 g and a negative cough test.

Results: The minimum and median follow-up was 12 months & 24 months respectively. Subjectively, 93.75 % of the patients rated themselves as continent, 2.08% as slightly incontinent, and 4.16 % as severely incontinent. The objective cure rate was 93.75%. The surgery failed in 3 patients (6.25%). 2 patients (4.16%) underwent repeat surgery. There was one case (2.08%) of vaginal erosion of mesh which required excision of the exposed part and one case (2.08%) of urinary retention requiring incision of the mesh at the center.

Conclusions: Transobturator approach of mid urethral sling surgery is a safe, effective and minimally invasive procedure for SUI with a very low rate of complications.


Serati M, Salvatore S, Uccella S, Artibani W, Novara G, Cardozo L, et al. Surgical treatment for female stress urinary incontinence: what is the gold-standard procedure? Int Urogynecol J Pelvic Floor Dysfunct. 2009;20:619-21.

Margareta N, Ann L, Othon L. The impact of female urinary incontinence and urgency on quality of life and partner relationship. Neurourol Urodyn. 2009;28(8):976-81.

Petros PE, Ulmsten UI. An integral theory of female urinary incontinence. Experimental and clinical considerations. Acta Obstet Gynecol Scand Suppl. 1990;153:7-31.

Costantini E, Lazzeri, M. Porena. Managing Complications after Midurethral Sling for Stress Urinary Incontinence. European Urology. 2007;5:232–40.

Delorme E. Transobturator urethral suspension; mini invasive procedure in the treatment of stress incontinence in women. Prog Urol. 2001;11:1306-13.

De Leval J. Novel surgical technique for the treatment of female stress urinary incontinence: transobturator vaginal tape inside-out. Eur Urol. 2003;44:724-30.

Bassem S, Mansour A, Ahmed S. El-Hefnawy, Adel N and Albair A. Minimum 2-year follow-up of mid-urethral slings, effect on quality of life, incontinence impact and sexual function. Int Urol J. 2010;21:1485-90.

Haliloglu B, Diaa E, Rizk E. Subjective versus objective measurement of surgical outcomes of treatment of female stress urinary incontinence: it is not just black and white. Int Urogynecol J. 2010;21:761–62.

Rui O, Francisco B, Pedro S, Alexandre R, Carlos S

Bai SW, Jeon MJ, Kim JY. Relationship between stress urinary incontinence and pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct. 2002;13:256.

Dmochowski RR, Blaivas JM, Gormley EA. Update of AUA Guideline on the Surgical Management of Female Stress Urinary Incontinence. Female Stress Urinary Incontinence Update Panel of the American Urological Association Education and Research, Inc. J Urol. 2010;183:1906-14.

Levin I. Surgical complications and medium-term outcome results of tension-free vaginal tape: a prospective study of 313 consecutive patients. Neurourol Urodyn 2004;23:7-9.

Rezapour M, Ulmsten. Tension-free vaginal tape (TVT) in women with mixed urinary incontinence - a long-term follow-up. Int Urogynecol J Pelvic Floor Dysfunct 12 (Suppl 2). 2001;S15-S18.

Deval B. Objective and subjective cure rates after trans-obturator tape (OBTAPE) treatment of female urinary incontinence. Eur Urol. 2006;49:373-7.

Bullock TL. Advances in female stress urinary incontinence: mid-urethral slings. BJU Int. 2006;98(Suppl 1):32-40.






Original Research Articles