Urethral slings placed by the transobturator approach: evolution in the technique and review of the literature.

Midurethral slings have proven to be efficacious in the surgical treatment of stress urinary incontinence (SUI) in women. A relatively new approach to the midurethral sling technique is the transobturator route for placement of the sling. This approach offers the theoretical safety advantage of avoiding the retroperitoneal space. The procedure has been pioneered in Europe and is now being practiced in the United States. In this article, we describe the theory behind urethral slings for SUI, the anatomy of the obturator canal, and early data on the safety and efficacy of transobturator urethral slings in the treatment of SUI.