A transobturator technique was developed for treating male urinary incontinence. This approach helped to design specific instruments to pass around the ischio-pubic branches of the male pelvis from inside to outside (i.e from the suburethral space to the thigh fold). The inside-out transobturator sling technique uses specific instruments and a polypropylene mesh with two arms that are passed inside to outside through the obturator foramens, pulled for compressing the bulbar urethra upward, and tied to each other across the midline. The mesh passes around the ischio-pubic branch before being tied under the bulbar urethra where it brings tension and support.
