INTRODUCTION AND HYPOTHESIS: The objective is to describe the anatomical position of tension-free vaginal tape Secur (TVT-S) in the U position regarding possible injury and fixation site. METHODS: We placed TVT-S inserters bilaterally in 13 embalmed and five fresh frozen female bodies. After dissection, we measured distances from the obturator bundle. RESULTS: In embalmed bodies, the mean distance of TVT-S from the obturator bundle was 2.83 cm (standard deviation (SD) 0.87 cm) on the left, 2.92 cm (SD 1.24 cm) on the right. Perforation of the fascia of obturator internus muscle occurred in 38.5%. In fresh frozen bodies, results were fundamentally similar (p > 0.05). CONCLUSIONS: There is a risk of injury to the obturator bundle and urinary bladder during TVT-S; however, there is a significant risk of inserting the TVT-S inserter outside the obturator internus muscle (into the lesser pelvis). The position of TVT-S does not change significantly after legs mal-positioning.

1st Faculty of Medicine and General Teaching Hospital Department of Gynaecology and Obstetrics Charles University Prague Apolinarska 18 Prague 2 12000 Czech Republic

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Br J Obstet Gynaecol. 1999 Apr;106(4):345-50 PubMed

Int Urogynecol J Pelvic Floor Dysfunct. 2007 Feb;18(2):183-7 PubMed

Int Urogynecol J Pelvic Floor Dysfunct. 2001;12 Suppl 2:S5-8 PubMed

Scand J Urol Nephrol. 1995 Mar;29(1):75-82 PubMed

Ceska Gynekol. 2007 Jan;72(1):42-9 PubMed

Int Urogynecol J. 2010 Sep;21(9):1179-80 PubMed

Int Urogynecol J Pelvic Floor Dysfunct. 2009 Jun;20(6):681-8 PubMed

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Int Urogynecol J Pelvic Floor Dysfunct. 2008 Nov;19(11):1581-3 PubMed

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J Gynecol Obstet Biol Reprod (Paris). 2008 May;37(3):229-36 PubMed

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