Safety of a new transobturator suburethral synthetic sling (TVT-O) procedure during the training phase

The TVT-O (Ethicon, Somerville, NJ) is a new transobturator suburethral synthetic sling used in the treatment of female stress urinary incontinence (SUI). This study aimed to evaluate the complication rates and procedural times associated with performing this procedure during a period of transition from the retropubic tension-free vaginal tape (TVT) procedure to the transobturator TVT-O procedure.

We performed a retrospective analysis of the first 50 patients to undergo the TVT-O procedure in one gynaecologist's practice. All patients had SUI or mixed urinary incontinence. Operative times and intraoperative and perioperative complications were recorded. At the two-week and six- to eight-week postoperative reviews, a urogenital history and examination were performed.

The only complications encountered were two cases (4%) of urinary tract infection and one case (2%) of superficial wound infection. There were no cases of postoperative voiding difficulty, hemorrhage, hematoma, persistent groin pain, or vascular or visceral injuries. The mean procedural time was 21 minutes.

These preliminary results indicate that the TVT-O procedure is a safe treatment for female SUI even during the training phase. In light of the safety and the ease of transition to this technique, this finding is encouraging for surgeons who are making the transition from other surgical procedures for female SUI to the transobturator TVT-O.