Tape related complications of mid- urethral sling procedures for female urinary stress incontinence

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Introduction. The mid-urethral sling procedures (MUS), like tension free vaginal tape (TVT) or transobturator tape (TOT) procedures are recent modalities for managing female urinary stress incontinence. They have been rapidly gaining popularity worldwide but little has been published to date on the nature and symptoms of associated complication

Material and methods. From April 1998 till now, about 300 patients underwent MUS procedure in our department. During the last five years twenty patients underwent, and three refused corrective surgery for complications resulting from the MUS, another two patient are only being observed. Their records were reviewed to retrieve data on presenting symptoms and signs, diagnostic tests, surgical procedures, and outcomes

Results. One patient had tape erosion into the bladder, six had vaginal tape erosion (one with concomitant urethral obstruction ), and another eighteen had an obstructed urethra. The more common presenting symptoms were persistent urethral pain, recurrent urinary tract infection, urgency, urge incontinence, and vaginal discharge. Twenty patients required partial tape removal or tape incision which was carried out transvaginally in nineteen of them. One patient underwent cystotomy and excision of the intravesical part of an eroded tape. Two patients with asymptomatic vaginal erosion are only being observed. No formal urethrolysis was performed in any case. The mean follow-up after corrective surgery in 20 patients was 14.8 months (range 6-48) during which fifteen patients remain continent and symptom free.

Conclusions. Urologists and gynecologists should be aware of the nature and symptoms of tape-related complications associated with a MUS procedure for prompt diagnosis and appropriate postoperative treatment managemen.

About the authors

A. Tsivian

Author for correspondence.
Email: info@eco-vector.com

Dept. Urologic Surgery

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