[Management of chronic pelvic and perineal pain after suburethral tape placement for urinary incontinence].

INTRODUCTION

The surgical treatment of stress urinary incontinence is essentially based on TVT or TOT suburethral tape placement. The purpose of this article is to review the literature on the diagnostic and therapeutic approach to chronic pelvic and perineal pain following suburethral tape placement for urinary incontinence.

MATERIAL AND

METHODS

A comprehensive review of the literature was performed by searching Pubmed for articles on pelvic and perineal pain following suburethral tape placement.

RESULTS

The role of suburethral tape in the pathogenesis of pain is essentially based on the fact that pain occurs immediately or over the days following tape placement. The clinical features are usually fairly nonspecific, with pelvic myofascial pain, possibly associated with direct or indirect nerve lesions (obturator nerve or pudendal nerve). Local infiltration of anaesthetic along the tape is performed for diagnostic purposes to confirm the aetiology of the pain and can also have a temporary therapeutic efficacy. Surgical removal of the tape was performed with satisfactory intermediate-term results in about two out of three cases.

CONCLUSION

The frequency of chronic pelvic and perineal pain following suburethral tape placement appears to be underestimated. The diagnostic approach is based on complete clinical examination and infiltration along the tape and any nerves involved. Surgical removal of the tape provides the best intermediate-term analgesic results.