Differentiate TOT and TVT slings in terms of path and typical risk profiles.

• A. TOT passes under the obturator foramen; TVT passes through the retropubic space; both treat SUI but have similar risk profiles.
• B. TOT passes through the retropubic space; TVT passes under obturator foramen; both treat SUI but have identical risk profiles.
• C. TOT passes under the obturator foramen; TVT passes through the retropubic space; both treat SUI but have different risk profiles (e.g., bladder injury risk with TVT).
• D. TOT and TVT are the same procedure with no differences.

Answer: (C)

The main idea is that where the tape travels in each procedure determines which nearby structures it may affect and what complications are more likely. A transobturator tape is placed by a path that goes under the obturator foramen, exiting laterally through the groin area. A tension-free vaginal tape uses a retropubic (behind the pubic bone) route, passing through the retropubic space toward the lower abdominal area. This difference in trajectory explains the distinct risk profiles: the retropubic path brings the tape close to the bladder, making bladder injury a higher concern with TVT, whereas the transobturator route avoids the bladder but can be associated with obturator region irritation, groin or thigh pain, or nerve-related symptoms. Both aim to support the urethra to treat stress urinary incontinence, but their complication patterns differ because of where the tape travels.