TOT Approach for SUI Effective

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The transobturator (TOT) approach from outside to inside is a highly effective treatment for stress urinary incontinence (SUI) in women, and it is associated with low morbidity, according to researchers in Saudi Arabia.

Waleed Al Taweel, MD, of King Faisal Specialist Hospital & Research Centre, and Danny M. Rabah, MD, of King Khalid University Hospital, both in Riyadh, analyzed results from 52 women with SUI who underwent the procedure. The mean age was 50 years (range 37 to 72 years) and the minimum follow-up was 24 months (range 24 to 30 months).

Two patients were lost to follow-up after 12 months and three patients did not come for the 24-month evaluation. The mean operative time was 18 minutes and the average blood loss was 57 cc. SUI was cured or improved in 92% of cases after 12 months and 85% after 24 months, the investigators reported in the Canadian Urological Association Journal (2010;4:33-36).

The researchers defined the cure of SUI as the disappearance of subjective and objective SUI using the urogenital distress inventory (UDI-6), urodynamic study after 12 months, and negative cough test on physical examination after 24 months. They defined objective improvement as a decrease in leakage using the pad weight test and subjective improvement as a decrease in the UDI-6 score.

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