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International Urogynecology Journal

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01-03-2012 | Original Article

Comparison of late complications of retropubic and transobturator slings in stress urinary incontinence

Authors: Eckhard Petri, Kiran Ashok

Published in: International Urogynecology Journal | Issue 3/2012

Abstract

Introduction and hypothesis

To compare the late complication profiles between retropubic and transobturator slings used for stress urinary incontinence was the objective of the study.

Methods

Between the years 2003 and 2010, 338 complications of midurethral slings were surgically managed in a tertiary referral center. For the purpose of study, we excluded slings that had materials other than monofilament polypropylene, patients with previous anti-incontinence surgeries, and patients who were suspected of having a neurologic bladder condition. This is a prospective and retrospective study of the complications of midurethral slings. The characteristics of complications in retropubic and transobturator routes were compared and analyzed.

Results

Two hundred eighty cases with midurethral sling complications were suitable for analysis. Of these, retropubic slings constituted 210 and transobturator 70. The time interval between the insertion of tape and onset of complications was similar in both groups. Within the two groups, obstructive symptoms were seen more frequently in the retropubic tapes group. Compared to the retropubic tapes group, the transobturator group had more number of complications related to persistent pain (10% tension-free vaginal tapes vs. 32% transobturator tapes), dyspareunia (3% vs. 18%), and tape-related infections (4% vs. 18%). There were no significant differences among the complication rates pertaining to de novo overactive bladder (49% vs. 44%), obstructive symptoms (48% vs. 30%), and contraction of sling material (5% vs. 8%).

Conclusions

Obstructive complications were seen more commonly in the retropubic tapes compared to the transobturator tapes. Transobturator tapes were more frequently associated with persistent pain, dyspareunia, and tape-related infections as compared to retropubic tapes.

Novara G, Ficarra V, Boscolo-Berto R, Secco S, Cavalleri S, Artibani W (2007) Tension-free midurethral slings in the treatment of female stress urinary incontinence: a systematic review and meta-analysis of randomized controlled trials of effectiveness. Eur Urol 52(3):663–678PubMedCrossRef

Novara G, Galfano A, Boscolo-Berto R, Secco S, Cavalleri S, Ficarra V, Artibani W (2008) Complication rates of tension-free midurethral slings in the treatment of female stress urinary incontinence: a systematic review and meta-analysis of randomized controlled trials comparing tension-free midurethral tapes to other surgical procedures and different devices. Eur Urol 53(2):288–308PubMedCrossRef

Tsivian A, Mogutin B, Kessler O, Korczak D, Levin S, Sidi AA (2004) Tension-free vaginal tape procedure for the treatment of female stress urinary incontinence: long-term results. J Urol 172(3):998–1000PubMedCrossRef

Kristensen I, Eldoma M, Williamson T, Wood S, Mainprize T, Ross S (2010) Complications of the tension-free vaginal tape procedure for stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 21(11):1353–1357CrossRef

Juma S, Brito CG (2007) Transobturator tape (TOT): two years follow-up. Neurourol Urodyn 26(1):37–41PubMedCrossRef

Chen Z, Chen Y, Du GH et al (2010) Comparison of three kinds of mid-urethral slings for surgical treatment of female stress urinary incontinence. Urologia 77(1):37–41PubMed

Bracq A, Fourmarier M, Boutemy F et al (2006) Urodynamic changes after transobturator suburethral tape. Prog Urol 16(1):62–66PubMed

Botros SM, Miller JJ, Goldberg RP et al (2007) Detrusor overactivity and urge urinary incontinence following trans obturator versus midurethral slings. Neurourol Urodyn 26(1):42–45PubMedCrossRef

Kaelin-Gambirasio I, Jacob S, Boulvain M, Dubuisson JB, Dällenbach P (2009) Complications associated with transobturator sling procedures: analysis of 233 consecutive cases with a 27 months follow-up. BMC Womens Health 9:28PubMedCrossRef

10.

Angioli R, Plotti F, Muzii L, Montera R, Panici PB, Zullo MA (2010) Tension-free vaginal tape versus transobturator suburethral tape: five-year follow-up results of a prospective, randomised trial. Eur Urol 58:671–677PubMedCrossRef

11.

Sajadi KP, Vasavada SP (2010) Overactive bladder after sling surgery. Curr Urol Rep 11(6):366–371PubMedCrossRef

12.

Holmgren C, Nilsson S, Lanner L, Hellberg D (2007) Frequency of de novo urgency in 463 women who had undergone the tension-free vaginal tape (TVT) procedure for genuine stress urinary incontinence—a long-term follow-up. Eur J Obstet Gynecol Reprod Biol 132(1):121–125PubMedCrossRef

13.

Schimpf MO, Patel M, O'Sullivan DM, Tulikangas PK (2009) Difference in quality of life in women with urge urinary incontinence compared to women with stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 20(7):781–786PubMedCrossRef

14.

Doo CK, Hong B, Chung BJ et al (2006) Five-year outcomes of the tension-free vaginal tape procedure for treatment of female stress urinary incontinence. Eur Urol 50(2):333–338PubMedCrossRef

15.

Wang W, Zhu L, Lang J (2009) Transobturator tape procedure versus tension-free vaginal tape for treatment of stress urinary incontinence. Int J Gynaecol Obstet 104(2):113–116PubMedCrossRef

16.

Ross S, Robert M, Swaby C et al (2009) Transobturator tape compared with tension-free vaginal tape for stress incontinence: a randomized controlled trial. Obstet Gynecol 114(6):1287–1294PubMedCrossRef

17.

Feng CL, Chin HY, Wang KH (2008) Transobturator vaginal tape inside out procedure for stress urinary incontinence: results of 102 patients. Int Urogynecol J Pelvic Floor Dysfunct 19(10):1423–1427PubMedCrossRef

18.

Roth TM (2007) Management of persistent groin pain after transobturator slings. Int Urogynecol J Pelvic Floor Dysfunct 18(11):1371–1373PubMedCrossRef

19.

Mazouni C, Karsenty G, Bretelle F, Bladou F, Gamerre M, Serment G (2004) Urinary complications and sexual function after the tension-free vaginal tape procedure. Acta Obstet Gynecol Scand 83(10):955–961PubMed

20.

Cholhan HJ, Hutchings TB, Rooney KE (2010) Dyspareunia associated with paraurethral banding in the transobturator sling. Am J Obstet Gynecol 202(5):481, e1-5PubMedCrossRef

21.

Latthe PM, Foon R, Toozs-Hobson P (2007) Transobturator and retropubic tape procedures in stress urinary incontinence: a systematic review and meta-analysis of effectiveness and complications. BJOG 114(5):522–531PubMedCrossRef

22.

Deffieux X, Daher N, Mansoor A, Debodinance P, Muhlstein J, Fernandez H (2010) Transobturator TVT-O versus retropubic TVT: results of a multicenter randomized controlled trial at 24 months follow-up. Int Urogynecol J Pelvic Floor Dysfunct 21(11):1337–1345CrossRef

23.

Charalambous S, Touloupidis S, Fatles G et al (2008) Transvaginal vs transobturator approach for synthetic sling placement in patients with stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 19(3):357–360PubMedCrossRef

24.

Mellier G, Mistrangelo E, Gery L, Philippe C, Patrice M (2007) Tension-free obturator tape (Monarc Subfascial Hammock) in patients with or without associated procedures. Int Urogynecol J Pelvic Floor Dysfunct 18(2):165–172PubMed

25.

But I (2005) Vaginal wall erosion after transobturator tape procedure. Int Urogynecol J Pelvic Floor Dysfunct 16(6):506–508PubMedCrossRef

26.

Domingo S, Alamá P, Ruiz N, Perales A, Pellicer A (2005) Diagnosis, management and prognosis of vaginal erosion after transobturator suburethral tape procedure using a nonwoven thermally bonded polypropylene mesh. J Urol 173(5):1627–1630PubMedCrossRef

27.

Novara G, Artibani W, Barber MD et al (2010) Updated systematic review and meta-analysis of the comparative data on colposuspensions, pubovaginal slings, and midurethral tapes in the surgical treatment of female stress urinary incontinence. Eur Urol 58(2):218–238PubMedCrossRef

28.

Lowery WJ, Dooley Y, Kost E (2010) Small-pore polypropylene slings: still out there. Int Urogynecol J Pelvic Floor Dysfunct 21(1):125–127CrossRef

29.

Flam F, Boijsen M, Lind F (2009) Necrotizing fasciitis following transobturator tape treated by extensive surgery and hyperbaric oxygen. Int Urogynecol J Pelvic Floor Dysfunct 20(1):113–115PubMedCrossRef

30.

Rardin CR, Moore R, Ward RM, Myers DL (2009) Recurrent thigh abscess with necrotizing fasciitis from a retained transobturator sling segment. J Minim Invasive Gynecol 16(1):84–87PubMedCrossRef

Title: Comparison of late complications of retropubic and transobturator slings in stress urinary incontinence
Authors: Eckhard Petri
Kiran Ashok
Publication date: 01-03-2012
Publisher: Springer-Verlag
Published in: International Urogynecology Journal / Issue 3/2012
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-011-1535-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Comparison of late complications of retropubic and transobturator slings in stress urinary incontinence

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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