The transobturator sling: newest tension-free suburethral sling for treatment of stress urinary incontinence.

T his innovative sling system places the sling between the obturator foramens using a perineal approach while preserving an intact retropubic space. Potential complications associated with tension-free sling systems that use needle-carrier placement through the retropubic space, such as the tension-free vaginal tape (TVT, Gynecare, Ethicon, Somerville, NJ, USA), are eliminated and routine cystoscopy is not required. The procedure is effective and safe for the primary treatment of stress urinary incontinence in patients with urethral hypermobility, intrinsic sphincter deficiency, or both. It is equally efficient in treatment of recurrent and mixed urinary incontinence. Short-term results are similar to those of the retropubic tension-free slings.