Managing complications of slings.

PURPOSE OF REVIEW: As newer materials and less invasive techniques emerge, treatment of stress urinary incontinence has increased over time. This shift has implications for the types of complications seen in contemporary practice compared to those even a few years ago. This review details prevention, diagnosis, and treatment of complications of sling surgery for stress urinary incontinence.

RECENT FINDINGS: Proper diagnosis and evaluation of stress urinary incontinence remains paramount in preventing surgical complications. Intraoperative complications, primarily bleeding and urinary tract injury vary depending on surgeon experience, operative technique and approach as well as prompt recognition of the injury. Postoperative complications include but are not limited to voiding dysfunction, urinary retention, vaginal extrusion and urinary tract erosion, thigh pain, and sexual dysfunction. Treatment relies on appropriate identification of the complication and may involve conservative and/or eventual surgical measures.

SUMMARY: As surgical treatment of stress incontinence evolves, thorough understanding of sling surgery and its attendant complications remain critical for the practicing physician.