This paper reports the efficacy and complications of the trans-obturator foramen procedure (TOT). The effect of TOT on co-existing urgency and urge incontinence and voiding difficulty were also noted. It reports on patients (31) undergoing TOT (Obtape) from April 2005 to April 2006, who were sent a questionnaire. The mean age was 53 years, mean parity 2.3, mean duration of incontinence 6.2 years and the mean duration of follow-up was 9 months. All patients had significant stress incontinence. Co-existing urge incontinence was present in 70%; no intraoperative complications. One patient had a urinary tract infection (UTI) and one, catheterisation for 5 days. A total of 16.6% of patients developed sling erosion. There was a 93% response rate to the postal survey, indicating a 31% complete cure of urinary incontinence; 65% a significant improvement and 3.5% failure. Urge incontinence disappeared in 66%, no de-novo urgency and 8% reported slower voiding. Satisfaction was 8.9 on a 1 - 10 Scale. The success rate of the TOT procedure was high, helping both stress and concomitant urge incontinence, but due to an unacceptably high erosion rate, Obtape was discontinued.

Automated peritoneal dialysis (APD) is increasingly being used for the treatment of end stage renal disease. We present our experience of APD at a government run tertiary care institute. APD was initiated for 22 patients between 2002 and 2010. On comparing APD and continuous ambulatory peritoneal dialysis (CAPD) patients, no difference in patient survival and technique survival was observed. CAPD patients had higher number of peritonitis episodes, greater decline in the serum albumin and a greater number of patients failed to achieve adequacy targets compared to APD.