Complications and their treatment after midurethral tape implantation using retropubic and transobturator approaches for treatment of female stress urinary incontinence

Abstract

IntroductionMidurethral tape implantation procedures currently are the first-line treatment for female stress urinary incontinence (SUI).AimTo estimate the most common intraoperative and postoperative complications and their treatment methods after midurethral tape implantation using retropubic (tension-free vaginal tape – TVT) and transobturator (TOT) approaches for the treatment of female SUI.Material and methodsA retrospective descriptive study was performed on 367 women operated on due to SUI in the period from 2004 to 2015. The SUI diagnosis was confirmed by clinical history and physical examination. According to the surgical technique that was chosen for SUI treatment, all the patients were divided into two groups: the TVT group (n = 112) and the TOT group (n = 255).ResultsIn total, in 31 (8.45%) of 367 patients complications were observed after midurethral tape implantation. In the TVT group 18 (16.07%) of 112 patients experienced surgery-related complications compared to 13 (5.1%) of 255 patients in the TOT group (p = 0.0005). The most common intraoperative complication in the TVT group was bladder perforation. In the TOT group we had only occasional intraoperative complications. Acute urinary retention was the most common postoperative complication in both groups. It was observed in 13 (11.6%) patients in the TVT group and in 5 (1.96%) patients in the TOT group.ConclusionsThe advantage of midurethral tape implantation using the TOT technique is that it is associated with lower incidence of intraoperative and postoperative complications compared to TVT. The most common complication in our series was acute postoperative urinary retention, which usually required an additional tape loosening procedure.

A retrospective analysis of perioperative complications associated with retropubic tension-free vaginal tape in 960 women

“…The types of specific postoperative complications which occurred, and their frequency are similar to those described in the literature [3,6,10,15,16]. Affecting 41 women, urinary retention and voiding problems were the most frequent complications in our study.…”

“…In comparison to previous studies reporting low numbers of urinary tract infections, making up less than 5% of all complications [14,15] or not reporting a single one [10], our study showed ten urinary tract infections which make up 13.7% of the complications. Several further studies did not refer to urinary tract infections when discussing postoperative complications [16,17].…”

“…Regarding the number of intraoperative complications, a wide range from 0.76 [6] to 16.58% [9] can be found in literature. Reported bladder injuries in connection with a TVT range from 1.79 to 5.8% [10][11][12].…”

Intraoperative and early postoperative complications in women with stress urinary incontinence treated with suburethral slings: a randomised trial

“…Price et al suggest pulling down the tape within 14 days of surgery [39]. In our practice, similarly to Barisiene et al [18], we mobilised the sling within 1 week postoperatively. Ripperda et al [40] tried to identify the predictive factors of early postoperative voiding dysfunction.…”

“…Intraoperative and post-operative complications were observed in 25% of the patients who had undergone the TVT procedure and in 12% who were operated on according to the TOT method. Other authors [13,[16][17][18]] report a high percentage of all complications associated with the TVT procedure: between 5.0% and 43.1%. Intraoperative complications were noted in 2.9-12.9% [9,13,19,20].…”