Transobturator tension-free vaginal tape compared with transobturator tape for treatment of female stress urinary incontinence: anatomical consideration
AIM: To evaluate the specific risks of injury to neural and vascular structures inherent of outside-in vs inside-out technique for treatment of the female stress urinary incontinence. METHODS: Eight freshly frozen, unembalmed female cadavers kept in a cold room were used. All specimens had a tape inserted from transobturator tension- free vaginal tape (TVT-O) and/or trans-obturator intra-vaginal slingplasty (O-IVS). After tape insertion, the cadavers were dissected, and the anatomical location of the track of each tape and the distence between the tape and blood vessels or nerves were measured and recorded. RESULTS: The mean distance between the tape and the vascular bundle: TVT-O technique 13.0 ± 1.0 (3 - 34) mm, O-IVS technique 37.0 ± 0.3(33 - 42)mm; The mean distance between the tape and the posterior branch of the obturator nerve: TVT-O technique 11.0 ± 0.7(3 - 15)mm, O-IVS technique 27.0 ± 0.5 (20 - 33) mm; The mean distance between the tape and the obturator canal: TVT-O technique 21.0 ± 0.3(18 - 24)mm, O-IVS technique 40.0 ± 0.4(33 - 44) mm. There were signaificant differences among the all values between TVT-O technique and O-IVS technique (P ＜ 0.01); CONCLUSION: TVT-O technique has a higher risk of injury to vascular and nerve structures. O-IVS technique may be safer in treatment with SUI, and can reduce the potential risk of injury to vascular and nerve structures.
NETL
NSTL
万方数据
维普
