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Published in: Current Bladder Dysfunction Reports 1/2015

01-03-2015 | Stress Incontinence and Prolapse (R Dmochowski, Section Editor)

Avoiding and Managing Complications of Synthetic Midurethral Slings

Authors: Mickey Karram, Elizabeth Timbrook Brown

Published in: Current Bladder Dysfunction Reports | Issue 1/2015

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Abstract

Synthetic midurethral slings have become the most popular and efficacious surgical intervention for women suffering from urinary stress incontinence. They include retropubic, transobturator, and single-incision slings. Numerous studies have demonstrated that these procedures are minimally invasive with a very low morbidity. The most common complications include bladder perforation, mesh erosion, and voiding dysfunction, which can usually be appropriately managed without any significant long-term sequelae. Pain and dyspareunia will occur in a small percentage of women for a variety of reasons that will be discussed. Life-threatening complications such as vascular or bowel injury have been reported as rare complications of retropubic synthetic midurethral slings.
Literature
1.•
go back to reference Fong ED, Nitti VW. Review article: Mid-urethral synthetic slings for female stress urinary incontinence. BJU Int. 2010;106:596–608. A thorough review of midurethral sling indications, work-up, placement, and complications with corresponding levels of evidence.CrossRefPubMed Fong ED, Nitti VW. Review article: Mid-urethral synthetic slings for female stress urinary incontinence. BJU Int. 2010;106:596–608. A thorough review of midurethral sling indications, work-up, placement, and complications with corresponding levels of evidence.CrossRefPubMed
2.
go back to reference Abouassaly R, Steinberg JR, Lemieux M, et al. Complications of tension-free vaginal tape surgery: multi-institutional review. BJU Int. 2004;94:110–3.CrossRefPubMed Abouassaly R, Steinberg JR, Lemieux M, et al. Complications of tension-free vaginal tape surgery: multi-institutional review. BJU Int. 2004;94:110–3.CrossRefPubMed
3.••
go back to reference Ogah J, Cody JD, Rogerson L. Minimally invasive synthetic suburethral sling operations for stress urinary incontinence in women. Cochrane Database Syst Rev. 2009;4:CD006375. A comprehensive review of midurethral sling indications, sling types, and complications with corresponding levels of evidence.PubMed Ogah J, Cody JD, Rogerson L. Minimally invasive synthetic suburethral sling operations for stress urinary incontinence in women. Cochrane Database Syst Rev. 2009;4:CD006375. A comprehensive review of midurethral sling indications, sling types, and complications with corresponding levels of evidence.PubMed
4.
go back to reference Wang AC. The techniques of trocar insertion and intraoperative urethrocystoscopy in tension-free vaginal taping: an experience of 600 cases. Acta Obstet Gynecol Scand. 2004;83:293.CrossRefPubMed Wang AC. The techniques of trocar insertion and intraoperative urethrocystoscopy in tension-free vaginal taping: an experience of 600 cases. Acta Obstet Gynecol Scand. 2004;83:293.CrossRefPubMed
5.
go back to reference Bodelsson G, Henriksson L, Osser S, Stjernquist M. Short term complications of the tension free vaginal tape operation for stress urinary incontinence in women. Br J Obstet Gynaecol. 2002;109:566–9.CrossRef Bodelsson G, Henriksson L, Osser S, Stjernquist M. Short term complications of the tension free vaginal tape operation for stress urinary incontinence in women. Br J Obstet Gynaecol. 2002;109:566–9.CrossRef
6.
go back to reference Flock F, Reich A, Muche R, Kreienberg R, Reister F. Hemorrhagic complications associated with tension-free vaginal tape procedure. Obstet Gynecol. 2004;104(5 Pt 1):989–94.CrossRefPubMed Flock F, Reich A, Muche R, Kreienberg R, Reister F. Hemorrhagic complications associated with tension-free vaginal tape procedure. Obstet Gynecol. 2004;104(5 Pt 1):989–94.CrossRefPubMed
7.
go back to reference Rigaud J, Pothin P, Labat JJ, et al. Functional results after tape removal for chronic pelvic pain following tension-free vaginal tape or transobturator tape. J Urol. 2010;184:610–5.CrossRefPubMed Rigaud J, Pothin P, Labat JJ, et al. Functional results after tape removal for chronic pelvic pain following tension-free vaginal tape or transobturator tape. J Urol. 2010;184:610–5.CrossRefPubMed
8.
go back to reference Abdel-Fattah M, Ramsay I, Pringle S, et al. Randomised prospective single-blinded study comparing ‘inside-out’ versus ‘outside-in’ transobturator tapes in the management of urodynamic stress incontinence: 1-year outcomes from the E-TOT study. BJOG. 2010;117:870–8.CrossRefPubMed Abdel-Fattah M, Ramsay I, Pringle S, et al. Randomised prospective single-blinded study comparing ‘inside-out’ versus ‘outside-in’ transobturator tapes in the management of urodynamic stress incontinence: 1-year outcomes from the E-TOT study. BJOG. 2010;117:870–8.CrossRefPubMed
9.
go back to reference Cadish LA, Hacker MR, Dodge LE, Dramitinos P, Hota LS, Elkadry EA. Association of body mass index with hip and thigh pain following transobturator midurethral sling placement. Am J Obstet Gynecol. 2010;203:508.e1–5.CrossRef Cadish LA, Hacker MR, Dodge LE, Dramitinos P, Hota LS, Elkadry EA. Association of body mass index with hip and thigh pain following transobturator midurethral sling placement. Am J Obstet Gynecol. 2010;203:508.e1–5.CrossRef
10.
go back to reference Abdel-Fattah M, Ford JA, Lim CP, Madhuvrata P. Single-incision mini-slings versus standard midurethral slings in surgical management of female stress urinary incontinence: a meta-analysis of effectiveness and complications. Eur Urol. 2011;60:468–80.CrossRefPubMed Abdel-Fattah M, Ford JA, Lim CP, Madhuvrata P. Single-incision mini-slings versus standard midurethral slings in surgical management of female stress urinary incontinence: a meta-analysis of effectiveness and complications. Eur Urol. 2011;60:468–80.CrossRefPubMed
11.
go back to reference Ross S, Robert M, Swaby C, et al. Transobturator tape compared with tension-free vaginal tape for stress incontinence: a randomized controlled trial. Obstet Gynecol. 2009;114(6):1287–94.CrossRefPubMed Ross S, Robert M, Swaby C, et al. Transobturator tape compared with tension-free vaginal tape for stress incontinence: a randomized controlled trial. Obstet Gynecol. 2009;114(6):1287–94.CrossRefPubMed
12.
go back to reference Sentilhes L, Berthier A, Loisel C, Descamps P, Marpeau L, Grise P. Female sexual function following surgery for stress urinary incontinence: tension-free vaginal versus transobturator tape procedure. Int Urogynecol J. 2009;20:393–9.CrossRef Sentilhes L, Berthier A, Loisel C, Descamps P, Marpeau L, Grise P. Female sexual function following surgery for stress urinary incontinence: tension-free vaginal versus transobturator tape procedure. Int Urogynecol J. 2009;20:393–9.CrossRef
13.
go back to reference Kaelin-Gambirasio I, Jacob S, Boulvain M, Dubuisson JB, Dällenbach P. Complications associated with transobturator sling procedures: analysis of 233 consecutive cases with a 27 months follow-up. BMC Womens Health. 2009;9:28.CrossRefPubMedCentralPubMed Kaelin-Gambirasio I, Jacob S, Boulvain M, Dubuisson JB, Dällenbach P. Complications associated with transobturator sling procedures: analysis of 233 consecutive cases with a 27 months follow-up. BMC Womens Health. 2009;9:28.CrossRefPubMedCentralPubMed
14.
go back to reference Barber MD, Kleeman S, Karram MM, et al. Transobturator tape compared with tension-free vaginal tape for the treatment of stress urinary incontinence: a randomized controlled trial. Obstet Gynecol. 2008;111:611–21.CrossRefPubMed Barber MD, Kleeman S, Karram MM, et al. Transobturator tape compared with tension-free vaginal tape for the treatment of stress urinary incontinence: a randomized controlled trial. Obstet Gynecol. 2008;111:611–21.CrossRefPubMed
15.
go back to reference Moore RD, Mitchell GK, Miklos JR. Single-center retrospective study of the technique, safety, and 12-month efficacy of the MiniArc single-incision sling: a new minimally invasive procedure for treatment of female SUI. Surg Technol Int. 2009;18:175–81.PubMed Moore RD, Mitchell GK, Miklos JR. Single-center retrospective study of the technique, safety, and 12-month efficacy of the MiniArc single-incision sling: a new minimally invasive procedure for treatment of female SUI. Surg Technol Int. 2009;18:175–81.PubMed
16.
go back to reference Duckett JR, Patil A, Papanikolaou NS. Predicting early voiding dysfunction after tension-free vaginal tape. J Obstet Gynaecol. 2008;28:89–92.CrossRefPubMed Duckett JR, Patil A, Papanikolaou NS. Predicting early voiding dysfunction after tension-free vaginal tape. J Obstet Gynaecol. 2008;28:89–92.CrossRefPubMed
17.•
go back to reference American College of Obstetricians and Gynecologists. Urinary incontinence in women. ACOG Practice Bulletin No. 63. Obstet Gynecol. 2005;105:1533–45. ACOG standard recommendations with levels of evidence are included with discussion of the history and physical, urodynamic indications, and management options for urinary incontinence.CrossRef American College of Obstetricians and Gynecologists. Urinary incontinence in women. ACOG Practice Bulletin No. 63. Obstet Gynecol. 2005;105:1533–45. ACOG standard recommendations with levels of evidence are included with discussion of the history and physical, urodynamic indications, and management options for urinary incontinence.CrossRef
Metadata
Title
Avoiding and Managing Complications of Synthetic Midurethral Slings
Authors
Mickey Karram
Elizabeth Timbrook Brown
Publication date
01-03-2015
Publisher
Springer US
Published in
Current Bladder Dysfunction Reports / Issue 1/2015
Print ISSN: 1931-7212
Electronic ISSN: 1931-7220
DOI
https://doi.org/10.1007/s11884-015-0288-5

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