{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T10:34:40Z","timestamp":1770287680653,"version":"3.49.0"},"reference-count":18,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2006,10,26]],"date-time":"2006-10-26T00:00:00Z","timestamp":1161820800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2006,12]]},"abstract":"<jats:p><jats:bold>Objectives\u2002<\/jats:bold> To identify the rate of, and risk factors for, lower urinary tract (LUT) injuries associated with the transobturator tension\u2010free vaginal tape (TOT) procedure.<\/jats:p><jats:p><jats:bold>Design\u2002<\/jats:bold> Retrospective cohort study.<\/jats:p><jats:p><jats:bold>Setting\u2002<\/jats:bold> Tertiary referral urogynaecology centre.<\/jats:p><jats:p><jats:bold>Population\u2002<\/jats:bold> 390 women who underwent transobturator suburethral tapes for management of urodynamic stress incontinence between July 2002 and January 2006.<\/jats:p><jats:p><jats:bold>Methods\u2002<\/jats:bold> Early cases were identified from theatre records and a case note review performed. From May 2005 (<jats:italic>n<\/jats:italic>= 94), data from an ongoing prospective audit were reviewed. Data for LUT injuries with TOT procedures were examined and routes of insertion were compared using Fischer\u2019s exact test.<\/jats:p><jats:p><jats:bold>Main outcome measures\u2002<\/jats:bold> Rate of LUT injuries associated with the TOT procedures. Assessment of factors increasing risk of LUT injury, and comparison of the \u2018outside\u2010in\u2019 and \u2018inside\u2013out\u2019 techniques.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> 241 women underwent TOT outside\u2013in technique and 148 of them underwent inside\u2013out technique. Four LUT injuries occurred (1%): two urethral injuries (0.5%) and two bladder injuries (0.5%). All LUT injuries occurred in the outside\u2013in group, although this difference did not reach significance (<jats:italic>P<\/jats:italic>= 0.146). Bladder injuries occurred in women who underwent concomitant vaginal surgery, while urethral injuries occurred in women undergoing secondary procedures.<\/jats:p><jats:p><jats:bold>Conclusion\u2002<\/jats:bold> LUT injury is an uncommon complication of the TOT procedures, and in our hands only occurred with the outside\u2013in technique. Intraoperative cystoscopy should be considered only in selected cases.<\/jats:p>","DOI":"10.1111\/j.1471-0528.2006.01097.x","type":"journal-article","created":{"date-parts":[[2006,10,26]],"date-time":"2006-10-26T15:19:05Z","timestamp":1161875945000},"page":"1377-1381","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":56,"title":["Lower urinary tract injuries after transobturator tape insertion by different routes: a large retrospective study"],"prefix":"10.1111","volume":"113","author":[{"given":"M","family":"Abdel\u2010Fattah","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I","family":"Ramsay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Pringle","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2006,11,10]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01902378"},{"key":"e_1_2_6_3_2","first-page":"1306","article-title":"Transobturator urethral suspension: mini\u2010invasive procedure in the treatment of stress urinary incontinence in women","volume":"11","author":"Delorme E","year":"2001","journal-title":"Prog Urol"},{"key":"e_1_2_6_4_2","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1016\/j.eururo.2003.09.003","article-title":"Novel surgical technique for treatment of female stress urinary incontinence: transobturator vaginal tape inside\u2010out","volume":"44","author":"De Leval J","year":"2003","journal-title":"Eur Urol"},{"key":"e_1_2_6_5_2","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1097\/01.ju.0000148364.13525.7b","article-title":"Transobturator vaginal tape inside out for the surgical treatment of female stress urinary incontinence: anatomical considerations","volume":"173","author":"Bonnet P","year":"2005","journal-title":"J Urol"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2006.05.015"},{"key":"e_1_2_6_7_2","first-page":"89","article-title":"Tension\u2010free Transobturator approach for female stress urinary incontinence","volume":"56","author":"Cindolo L","year":"2004","journal-title":"Minerva Urol Nefrol"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2004.04.030"},{"key":"e_1_2_6_9_2","first-page":"1","article-title":"Transobturator tape, bladder perforation, and paravaginal defect: a case report","volume":"26","author":"Smith PP","year":"2006","journal-title":"Int J Urogynaecol"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2006.06348.x"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1576\/toag.2005.7.3.192"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1297-9589(02)00389-2"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2005.04.016"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2005.11.012"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.3310\/hta7210"},{"key":"e_1_2_6_16_2","first-page":"227","article-title":"Suburethral tapes via the obturator route: is the TOT a simplification of the TVT?","volume":"15","author":"Mellier G","year":"2004","journal-title":"Int J Urogynaecol"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2005.07.019"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2005.09.019"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2005.08.003"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; 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