Complications associated with transobturator sling procedures: analysis of 233 consecutive cases with a 27 months follow-up

Abstract

BackroundThe transobturator tape procedure (TOT) is an effective surgical treatment of female stress urinary incontinence. However data concerning safety are rare, follow-up is often less than two years, and complications are probably underreported. The aim of this study was to describe early and late complications associated with TOT procedures and identify risk factors for erosions.MethodsIt was a 27 months follow-up of a cohort of 233 women who underwent TOT with three different types of slings (Aris®, Obtape®, TVT-O®). Follow-up information was available for 225 (96.6%) women.ResultsThere were few per operative complications. Forty-eight women (21.3%) reported late complications including de novo or worsening of preexisting urgencies (10.2%), perineal pain (2.2%), de novo dyspareunia (9%), and vaginal erosion (7.6%). The risk of erosion significantly differed between the three types of slings and was 4%, 17% and 0% for Aris®, Obtape® and TVT-O® respectively (P = 0.001). The overall proportion of women satisfied by the procedure was 72.1%. The percentage of women satisfied was significantly lower in women who experienced erosion (29.4%) compared to women who did not (78.4%) (RR 0.14, 95% CI 0.05-0.38, P < 0.001).ConclusionLate post operative complications are relatively frequent after TOT and can impair patient's satisfaction. Women should be informed of these potential complications preoperatively and require careful follow-up after the procedure. Choice of the safest sling material is crucial as it is a risk factor for erosion.

Early Experience with Transobturator Tape in Management of Female Stress Urinary Incontinence

“…However the mean age is lesser than Moore et al (56.8 years) 11 and Isabelle et al (57.9 years) 12 .…”

The Effectiveness And Complications of Transobturator Tape Operation: Analysis of 120 cases

“…Arrabal-Polo ve arkadaşları yaptıkları çalışmada komplikasyon oranını %12 olarak bildirmişlerdir (14). Kaelin-Gambirasio ve arkadaşları da benzer komplikasyon oranları bildirmişlerdir (15) . Bizim çalışmamızda elde ettiğimiz %15'lik erken dönem komplikasyon oranı TOT operasyonun kısa dö-nem sonuçlarının güvenilir olduğu bilgisini destekler niteliktedir.…”

“…Bizim oranımız Latthe ve arkadaşlarının yaptıkları derleme ve meta analiz sonuçlarına göre düşüktür (22). Erozyon gelişiminde bireysel faktörlerin yanında kullanılan sling materyali ve cerrahi teknikte mutlaka önemlidir (15). Bizim tüm hastalarımızda makropor (100 µ) tip I Advantage™ mesh kullanılması ve standart cerrahi tekniklerin titizlikle uygulanması düşük oranın elde edilme nedeni olabilir.…”

To evaluate the safety and efficacy of the TVT-Secur procedure in the treatment of stress urinary incontinence in women

“…Two patients who presented with vaginal discharge, dyspareunia and hispareunia, and were detected to have vaginal tape exposures, were treated initially using antibiotics and oestrogen creams, as in a study reflecting management of erosions by Kaelin-Gambirasio et al 14 In the absence of improvement, in both patients, the central part of the tape had to be excised to control exposure and infection.…”