Anatomical relationship and fixation of tension-free vaginal tape Secur

Objective  The objective is to describe the anatomical localisation of tension-free vaginal tape Secur (TVT-S) in the H-position regarding possible injury of vessels and fixation site. Methods  We placed TVT-S inserters bilaterally in 14 embalmed and five fresh frozen female bodies. After dissection, we measured distances from the obturator bundle (obturator nerve and obturator vessels). Results  In embalmed bodies, the mean distance of TVT-S from the obturator bundle was 3.05 cm (standard deviation (SD) 1.18 cm) on the left, 3.07 cm (SD 1.17 cm) on the right. Perforation of the fascia of obturator internus muscle occurred in 46.4%. In fresh frozen bodies, results were fundamentally similar. Injury of variable vessels can occur. Conclusion  There is a minimal risk of injury to the obturator bundle during TVT-S; however, there is a significant risk of inserting the TVT-S inserter into the obturator fossa. The position of TVT-S does not change significantly after legs mal-positioning.