Transobturator tape as a day surgery procedure: a case control study.

This study aims to assess the suitability of the transobturator tape (TOT) as a day surgery procedure. A retrospective study of all the patients who underwent TOT as a day surgery procedure, at a tertiary referral centre in the south-west of Scotland, over a 3-year period (August 2002-July 2005). The outcome measures were as follows: complication rates (both intra- and immediate postoperative), voiding dysfunction rates, analgesic requirements and unscheduled in-patient ward admission following the procedure. One hundred and sixty-seven case notes were examined; the mean operating time was 14.7 min (range: 12-28 min, median: 14 min). 97.8% of patients had blood loss <100 ml and the mean blood loss was 54 ml (range: 10-500 ml). None of the patients had major complications such as urethral or bladder injury or anaesthetic complications. 79.6% of patients had satisfactory postoperative voiding pattern achieved within the time frame of the DSU (08:30-17:00 hours). No patient had complete urinary retention. However, 34 patients (20.4%) failed to achieve satisfactory voiding within that time frame and warranted in-patient admission. Three other patients required in-patient admission; the reasons being vaginal bleeding (n=1), postoperative nausea and vomiting (n=1) and postoperative pain (n=1). Therefore, a total of 37 patients required in-patient ward admission, with an admission rate of 22.2%. In conclusion, the transobturator tape procedure is suitable as a day surgery procedure in selected patients. There is minimal peri-operative morbidity, and nearly 80% of patients are discharged home within the scheduled time frame.