An inexpensive modified transobturator vaginal tape inside-out procedure for the surgical treatment of female stress urinary incontinence.

Introduction and hypothesis: The purpose of this study was to evaluate the safety and efficacy of a modified transobturator vaginal tape inside-out (TVT-O) procedure for stress urinary incontinence (SUI) using custom-tailored polypropylene mesh and helical needles.

Methods: A 1x15-cm mesh made from the Gynemesh is positioned without tension under the mid-urethra using custom-made helical needles through the obturator.

Results: The procedure was carried out in 80 consecutive patients (mean age 65.0+/-13.2 years). The mean operative time was 15 min (range 6-22 min). All patients had a follow-up visit at 1 year after surgery. Of the 80 patients, 75 (93.68%) were cured, and 5 (6.2%) were improved; no failure occurred. No bladder or urethral injuries and no vascular or neurological complications were encountered.

Conclusion: Our modified TVT-O procedure is a simple, safe, efficacious, and economic surgical procedure for SUI. The technique avoids damage to the urethra and bladder. The promising results are currently under evaluation.