Transobturator versus transabdominal mid urethral slings: A multi-institutional comparison of obstructive voiding complications

Allen F. Morey, Andrew R. Medendorp, Mark W. Noller, Rafael V. Mora, Kevin C. Shandera, John P. Foley, Luis R. Rivera, Juan A. Reyna, Patricia J. Terry

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

Purpose: In the last year TO slings have become an increasingly popular alternative to TA slings for the surgical treatment of SUI. Proposed advantages of the transobturator approach include improved speed, safety and the reduction of obstructive complications. We assessed outcomes of TO and TA slings in a large series of women treated at several institutions to compare the rate of obstructive complications from these procedures. Materials and Methods: We reviewed the charts of 504 consecutive women who had synthetic mid urethral sling procedures (154 TO or 350 TA) performed by 24 different urologists for SUI at 8 institutions from 2002 to 2004. Obstructive complications were defined as increased PVR (greater than 100 cc), or the need for CIC, prolonged Foley catheter drainage or urethrolysis. Results: While TO and TA sling procedures appeared to be similarly efficacious in eliminating the need for incontinence pad use (TO 89%, TA 86%, p = 0.36), the transobturator approach was associated with fewer obstructive complications (TO 11.0%, TA 18.3%, p <0.05). Urethrolysis was required in none of the 154 TO cases and 8 of 350 (2.3%) TA cases. Concomitant pelvic surgery did not significantly increase the likelihood of obstructive voiding complications in either group. Conclusions: Although TO and TA sling procedures had similar short-term results for decreasing pad use in patients with stress urinary incontinence, the transobturator approach is associated with fewer obstructive voiding complications.

Original languageEnglish (US)
Pages (from-to)1014-1017
Number of pages4
JournalJournal of Urology
Volume175
Issue number3
DOIs
StatePublished - Mar 2006

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Suburethral Slings
Incontinence Pads
Stress Urinary Incontinence
Drainage
Catheters
Safety

Keywords

  • Surgery
  • Urinary catheterization
  • Urinary incontinence
  • Urinary retention

ASJC Scopus subject areas

  • Urology

Cite this

Transobturator versus transabdominal mid urethral slings : A multi-institutional comparison of obstructive voiding complications. / Morey, Allen F.; Medendorp, Andrew R.; Noller, Mark W.; Mora, Rafael V.; Shandera, Kevin C.; Foley, John P.; Rivera, Luis R.; Reyna, Juan A.; Terry, Patricia J.

In: Journal of Urology, Vol. 175, No. 3, 03.2006, p. 1014-1017.

Research output: Contribution to journalArticle

Morey, AF, Medendorp, AR, Noller, MW, Mora, RV, Shandera, KC, Foley, JP, Rivera, LR, Reyna, JA & Terry, PJ 2006, 'Transobturator versus transabdominal mid urethral slings: A multi-institutional comparison of obstructive voiding complications', Journal of Urology, vol. 175, no. 3, pp. 1014-1017. https://doi.org/10.1016/S0022-5347(05)00412-X
Morey, Allen F. ; Medendorp, Andrew R. ; Noller, Mark W. ; Mora, Rafael V. ; Shandera, Kevin C. ; Foley, John P. ; Rivera, Luis R. ; Reyna, Juan A. ; Terry, Patricia J. / Transobturator versus transabdominal mid urethral slings : A multi-institutional comparison of obstructive voiding complications. In: Journal of Urology. 2006 ; Vol. 175, No. 3. pp. 1014-1017.
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AU - Rivera, Luis R.

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