Both the middle and distal sections of the urethra may be regarded as optimal targets for ‘outside-in’ transobturator tape placement

Purpose To investigate whether the position of the tape under the urethra may influence ‘outside-in’ transobturator sling (TOT) outcome. Methods The study comprised 141 women who underwent TOT for clinically and urodynamically proved stress urinary incontinence. The postoperative ultrasound examination with an endovaginal biplane probe was performed before discharging the patients from hospital. The measurements obtained described the position of the tape relative to the urethra and pubic symphysis, as well as anatomical relationships in the anterior compartment. Results Ninety-six (68.1 %) patients were cured, 27 (19.1 %) significantly improved, and in 18 cases (12.7 %), the surgery failed. The tape position under the midurethra (40–70th percentile of the urethral length) or distal urethra (>70th percentile) coincided with better results (cure rate 67.1 and 82.4 %, respectively) than the location in the proximity of the bladder neck (