Abstract:

The aim of this article is to present a new, modified shorter obturator sling with an inside-out transobturator trajectory for the treatment of female stress urinary incontinence (SUI). It is a method that proves efficient, is reproducible, and is associated with less postoperative pain when compared with the conventional method. The modified procedure involves the use of less tape and reduced dissection in the obturator space, while pursuing a more medial approach. Tape length was shortened, with placement of non-absorbable suture loops at either end to adjust the sling. At the mid-portion of the sling, a removable loop suture ensures equidistance. This is the only mini-sling that can be adjusted allowing one to modify terminal placement along an anterior/posterior axis. The incidence of immediate postoperative groin pain was reduced by 35% in the modified technique as compared with the original inside-out transobturator approach. There was also reduction of immediate pain severity by +/– 50%. In addition, the modified approach required less analgesics, less time in the operating room, and a shortened time until discharge home.

Authors:

Jessica Shepherd, MD, MBA, Assistant Professor, Director of Minimally Invasive Gynecology, Department of Obstetrics and Gynecology, University of Illinois at Chicago College of Medicine, Chicago, Illinois, Joseph L. Hudgens, MD, Owensboro Health Women’s Center, Owensboro, Kentucky, Gratis Faculty, University of Louisville, Owensboro, Kentucky, Marvin A. Yussman, MD, Professor, Department of Obstetrics, Gynecology, and Women’s Health, University of Louisville School of Medicine, Louisville, Kentucky, Shan M. Biscette, MD, Assistant Professor, Department of Obstetrics, Gynecology, and Women’s Health, University of Louisville School of Medicine, Louisville, Kentucky, Resad Pasic, MD, PhD, Professor, Department of Obstetrics, Gynecology, and Women’s Health, University of Louisville School of Medicine, Louisville, Kentucky

PMID: 24081842

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