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TVT-S in the U position—anatomical study

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Abstract

Introduction and hypothesis

The objective is to describe the anatomical position of tension-free vaginal tape Secur (TVT-S) in the U position regarding possible injury and fixation site.

Methods

We placed TVT-S inserters bilaterally in 13 embalmed and five fresh frozen female bodies. After dissection, we measured distances from the obturator bundle.

Results

In embalmed bodies, the mean distance of TVT-S from the obturator bundle was 2.83 cm (standard deviation (SD) 0.87 cm) on the left, 2.92 cm (SD 1.24 cm) on the right. Perforation of the fascia of obturator internus muscle occurred in 38.5%. In fresh frozen bodies, results were fundamentally similar (p > 0.05).

Conclusions

There is a risk of injury to the obturator bundle and urinary bladder during TVT-S; however, there is a significant risk of inserting the TVT-S inserter outside the obturator internus muscle (into the lesser pelvis). The position of TVT-S does not change significantly after legs mal-positioning.

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Acknowledgements

We would like to thank to I. Vítková MD, Head of Institute of Pathology of the First Faculty of Medicine and General Teaching Hospital, for allowing us to perform research at the Institute of Pathology, for scheduling the dissections and for coping with our demands. We would also like to thank to academic artist I. Helekal, medical illustrator of Institute of Anatomy of the First Faculty of Medicine, for drawing Fig. 1. This study was supported by the Internal Grant Agency of The Ministry of Health of the Czech Republic, grant NS 10586-3/2009, GIGH-0651-00-3-223 and by project of The Ministry of Education, Youth and Sports VZ 0021620806.

Conflicts of interest

Professor Martan is a preceptor of Gynecare.

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Authors and Affiliations

  1. First Faculty of Medicine and General Teaching Hospital, Department of Gynaecology and Obstetrics, Charles University in Prague, Apolinarska 18, Prague 2, 12000, Czech Republic

    Petr Hubka, Alois Martan & Jaromir Masata

  2. First Faculty of Medicine, Institute of Anatomy, Charles University in Prague, U Nemocnice 3, Prague 2, 12000, Czech Republic

    Ondrej Nanka & Milos Grim

  3. Institute of Computer Science, Academy of Sciences of the Czech Republic, EuroMISE Center, Pod Vodarenskou vezi 2, Prague 8, 18209, Czech Republic

    Jana Zvarova

Authors
  1. Petr Hubka
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  2. Ondrej Nanka
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  3. Alois Martan
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  4. Milos Grim
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  5. Jana Zvarova
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  6. Jaromir Masata
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Corresponding author

Correspondence to Petr Hubka.

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Hubka, P., Nanka, O., Martan, A. et al. TVT-S in the U position—anatomical study. Int Urogynecol J 22, 241–246 (2011). https://doi.org/10.1007/s00192-010-1239-5

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  • DOI: https://doi.org/10.1007/s00192-010-1239-5

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