Sling exposure after treatment of urinary incontinence with sub-urethral transobturator slings.

OBJECTIVE

Sub-urethral slings are the "gold standard" when treating female urinary incontinence, but placing the prosthetic material has its own specific complication, exposure.

STUDY

DESIGN

A retrospective study was performed on all patients who had a sub-urethral sling (TVT-O or TVT Secur) in Lille University Hospital Centre from 2006 to 2008. Follow-up was undertaken to look for re-intervention and to try to determine the risk factors.

RESULTS

A total of 386 patients were studied with a median follow-up of 4 years. The rate of exposure was 4.32%. TVT Secur gave rise to more exposures (13.79%) than TVT-O (3.51%) (p=0.0203). Association with Prolift for cure of prolapse significantly reduced the rate of exposure of sub-urethral slings (p=0.0161).

CONCLUSIONS

It seems important not to use mini-slings of the TVT Secur type as they induce a higher rate of prosthetic exposure. Cure of urinary incontinence may be done with cure of prolapse at the same surgical operation without higher risk of exposure.