INTRODUCTION AND HYPOTHESIS: The aim of the study was to exclude neurovascular 
damage due to prosthetic mini-invasive surgery using transobturator tape (TOT) 
by pre- and postoperative electromyography (EMG) of the striated urethral 
sphincter and a color Doppler ultrasonography evaluation of clitoral blood flow.
METHODS: A total of 25 women affected by clinical stress urinary incontinence 
(SUI) were enrolled. After undergoing urodynamic assessment, pelvic organ 
prolapse quantification, urine culture, Q-tip test, and stress test, each 
subject underwent color Doppler ultrasonography to record clitoral blood flow 
and EMG of the urethral sphincter with a needle electrode inserted through the 
mucosa into the muscle tissue before surgery. A single urogynecologist performed 
the TOT surgical technique for the treatment of all patients. Urogynecologic 
examination, EMG, and color Doppler ultrasound follow-up were performed at 1 and 
6 months after surgery.
RESULTS: At the urogynecologic examination performed 1 and 6 months after the 
TOT approach the stress test was negative, urethral hypermobility was reduced, 
and sling exposure was not observed for each patient. There was no statistically 
significant difference in electromyographic values (p > 0.05) in both the 
follow-ups with regard to baseline values. Pulsatility index (PI), resistance 
index (RI), and peak systolic velocity (PSV) values increased during the first 
follow-up (p < 0.01); PI and RI values increased during the second follow-up 
with respect to baseline values (p < 0.01)
CONCLUSIONS: TOT prosthesis surgery, avoiding denervation and devascularization 
of pelvic structures, does not damage the urethral sphincter.