Comparison of the outside-in and inside-out routes in the use of transobturator tapes for the treatment of stress urinary incontinence

Objective: To determine whether there are any differences in the results and complications of the treatment of stress urinary incontinence (SUI) using transobturator tapes (TOT) according to the insertion route: outside-in or inside-out. Material and methods: We performed a prospective cohort study of 254 patients treated through TOT for SUI. The insertion route was outside-in in 129 patients and inside-out in 125 patients. The results at 6 and 12 months and intraand post-operative complications were analyzed. Results: No differences were found in the results at 6 and 12 months according to the insertion route. In the early post-operative period, urinary retention was more frequent in women treated with the inside-out route (P=.02). No differences were found in the remaining complications studied. Conclusions: Our experience shows that similar results are obtained with both transobturator routes. However the occurrence of complications was slightly higher with the inside-out technique. © 2008 Sociedad Española de Ginecología y Obstetricia.