Polypropylene meshed tape may be placed at the mid urethra or bladder neck using retropubic or transobturator approaches. Various types of sub-urethral tapes inserted via the transobturator route (TVT obturator route [TVTO] and transobturator tape [TOT]) have been used for the treatment of SUI. In a systematic review, Latthe and co-workers (2007) evaluated the effectiveness and complications of TOTs as treatment of SUI. Randomized controlled trials (RCTs) that compared the effectiveness of TVTO or TOT with synthetic TVT by retropubic route for the treatment of SUI in all languages were included. Two reviewers extracted data on participants' characteristics, study quality, population, intervention, cure and adverse effects independently. There were 5 RCTs that compared TVTO with TVT and 6 RCTs that compared TOT with TVT. When compared by subjective cure, TVTO and TOT at 2 to 12 months were no better than TVT (odds ratio [OR] 0.85; 95 % confidence interval [CI]: 0.60 to 1.21). Adverse events such as bladder injuries (OR 0.12; 95 % CI: 0.05 to 0.33) and voiding difficulties (OR 0.55; 95 % CI: 0.31 to 0.98) were less common, whereas groin/thigh pain (OR 8.28; 95 % CI: 2.7 to 25.4), vaginal injuries or erosion of mesh (OR 1.96; 95 % CI: 0.87 to 4.39) were more common after tape insertion by the transobturator route. The authors concluded that the evidence for short-term superiority of effectiveness of TOTs is currently limited. Bladder injuries and voiding difficulties are lower, but the risk of vaginal erosions and groin pain is higher with TVTO/TOT. Methodologically sound and sufficiently powered RCTs with long-term follow-up are needed, and the results of continuing trials are awaited.