Traitement chirurgical de l'incontinence urinaire d'effort de la femme par bandelette transobturatrice

The aim of suburethral transobturator suspension is to cure the women stress urinary incontinence. The concept underlying this apparatus is based on several points: it reproduces the urethral fascia; it complies with Delancey's concept; it consists of a tension-free band through the soft structures of the obturator fossa; it is a perineal surgery. This surgery needs specific devices: a synthetic tape and a specific tool to introduce it, the tunnelling device. Respecting some technical landmarks are mandatory to ensure successful intervention: the vaginal incision must include all the thickness of the vaginal wall; the trans-obturated endpoint must be located at the level of the mid urethra; the tunnelling device must have a close contact with the ischiopubic bone; the finger inside the incision protects the urethra and drives the tunnelling device inside the vaginal incision.