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TOT – NEW GOLD STANDARD IN THE MANAGEMENT OF FEMALE STRESS INCONTINENCE?


Authors: I. Huvar
Authors‘ workplace: Gynekologicko-porodnické oddělení, Nemocnice Milosrdných bratří Brno
Published in: Urol List 2009; 7(2): 37-41

Overview

At the beginning of this century, no longer than six years after introducing TVT into clinical practice, French authors introduced new modification of suburethral syntetic tape. The trajectory was changed - from retro­pubic to transobturator.

This approach proved to be safer and enabled to eliminate, or at least minimize, the principal drawbacks of the original TVT, including frequent urinary bladder perforations and major vessels injury. In many departments this approach soon replaced the „classical method“ of TVT and has become the most frequent method in the management of female stress incontinence. Until the end of 2007 almost 200 000 procedures were performed and its number has been quickly increasing. It is associated with lower incidence of intra-operative and post-operative complications while offering efficiency comparable to TVT. Thus it became in most departments the method of choice in the management of female stress incontinence.

KEY WORDS

urinary incontinence, surgical treatment of urinary, incontinence, TOT, TVT-O


Sources

1. Delorme E. Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women. Prog Urol 2001; 11: 1306.

2. De Leval J. Novel surgical technique for the treatment of female stress urinary incontinence: transobturator vaginal tape: inside-out. Eur Urol 2003; 44: 724.

3. Bonnet P et al. TOT inside out for the surgical treatment of female stress urinary incontinence: anatomical considerations. J Urol April 2005; 173: 1223– 1228.

4. Minaglia S et al. Bladder injury during transobturator sling. Urology 2004; 64: 376–377.

5. De Tayrac R et al. A prospective randomizes trial comparing TVT and TOT for surgical treatment of stress urinary incontinence. Am J Obst Gynec 2004; 190: 602–660.

6. De Tayrac R et al. TOT had similar cure rate and complication rates to TVT for stress urinary incontinence. Obstet Gynecol 2004; 190: 602–608.

7. Costa P, Delmas V. TOT procedure – „inside out or outside in“: current concepts and evidence base. Curr Opin Urol 2004; 14 : 313–315.

8. Costa P et al. Surgical treatment of female stress urinary incontinence with T.O.T uratape: Short term results of a prospective multicentric study. Europ Urol 2004; pub. on-line 18.3.2004.

Labels
Paediatric urologist Urology
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