Transobturator tension free vaginal tapes and bladder injury

Tension free vaginal tapes have transformed the surgical management of female urodynamic stress incontinence (USI). Transobturator approach of tension free vaginal tapes are emerging as one of the surgical options for USI.

A literature search to answer question of routine cystoscopy during transobturator tape procedures.

Though, both TOT and TVT-O has been shown not to enter pelvis on anatomical dissection on female cadavers, many cases of bladder injury have been reported. Delorome and De Leval strongly suggest avoiding routine cystoscopy during insertion. Avoidance of cystoscopy means shorter operating time as well as less costly for patients. We recommend that routine cystoscopy at least need to be considered in selected group patients. In cases of associated pelvic surgery or presence of prolapse, previous retropubic surgery or difficult insertion of the tapes, cystoscopy could be considered. Further, large randomised clinical trials are needed to asses TVT, TOT and TVT-O in-order to conclude the question of routine cystoscopy or not.