Complications of mid-urethral slings for treatment of stress urinary incontinence.

OBJECTIVE

To compare the incidence of complications associated with the use of retropubic tension-free vaginal tape (TVT) and transobturator tension-free vaginal tape (TVT-O) for the management of stress urinary incontinence (SUI).

METHODS

In a cross-sectional study, 1081 patients were treated for SUI via mid-urethral slings, and the outcomes of those treated via TVT and those treated via TVT-O were compared. Patients who suffered from recurrent or mixed urinary incontinence were excluded.

RESULTS

Group 1 included patients treated via TVT (n=207) and group 2 included those treated with TVT-O (n=570). There was a higher incidence of bladder perforation (5.4% versus 0.6%; P=0.001) and hematoma formation (9.1% versus 1.5%; P=0.001) in group 1 than in group 2. Compared with group 1, there was higher incidence of vaginal wall perforation in group 2 (0.0% versus 3.8%, P=0.044). The rate of intraoperative complications was not related to patient age, body mass index, or parity. Of the patients who did not leak urine during a cough test 1 month after surgery, 90.9% still had a negative cough test at the long-term follow-up.

CONCLUSION

TVT-O was superior to TVT with regard to the incidence of bladder perforation and hematoma formation, but it resulted in more vaginal wall injuries.