An early complication of Transobturator tape: Non-infective adductor internus myositis

The transobturator tape (TOT) procedure is generally felt to be a safer surgical alternative to the ten sion-free vaginal tape procedure for women with stress urinary incontinence. We report a case of adductor internus myositis not associated with infection following the TOT procedure. To our knowledge this is the first case of this type reported in the literature. A 43 year old lady underwent a straightforward elective TOT procedure. There were no intraoperative complications. Immediately following the procedure she complained of pain in her right thigh. MRI confirmed abnormal oedema within the antero-inferior aspect of the right obturator internus muscle consistent with myositis secondary to tape insertion. The tape was removed the following day in theatre, following which her pain resolved. This case highlights a previously unreported complication as a result of the TOT procedure.

Ten-Year Outcomes of Transobturator Mid-Urethral Sling for Treatment of Stress Urinary Incontinence in Hong Kong Chinese Women with or without Reconstructive Pelvic Floor Surgery

Objective: To evaluate the outcomes of transobturator mid-urethral sling (TO-MUS) with or without reconstructive pelvic floor surgery (RPFS) in Chinese women with stress urinary incontinence (SUI) after 10 years. Methods: This was a prospective observational study on Chinese women undergoing the insertion of TO-MUS with or without RPFS. All patients were assessed at 1-year and 10-year by urodynamic study (UDS). Objective cure was defined as the absence of urine leakage during provocative maneuvers on filling cystometry. Data regarding subjective outcome (patient perception), quality of life changes (Urogenital Distress Inventory-short form (UDI-6), Incontinence Impact Questionnaire-short form (IIQ-7)) and adverse events were also collected. Results: Of 104 eligible patients, 99 patients completed the 10-year evaluation. 57 patients (57.6%) underwent TO-MUS only and 42 patients (42.4%) underwent TO-MUS with concomitant RPFS. At 10-year follow-up, the overall objective cure rate was 86.9% and overall subjective cure rate was 80.8%. In TO-MUS only group, the objective and subjective cure rates at 10-year were 84.2% and 78.9% respectively. In TO-MUS with RPFS group, the objective and subjective cure rates at 10-year were 90.5% and 83.3% respectively. Compared TO-MUS only group with TO-MUS with RPFS group, there were no statistically significant differences in objective cure rate (84.2% vs. 90.5%, p = 0.55) and subjective cure rate (78.9% vs. 83.3%, p = 0.58). Conclusion: TO-MUS is an effective treatment for SUI in Hong Kong Chinese women. Concomitant RPFS during the procedure of TO-MUS does not affect the success.