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Short term complications of the tension free vaginal tape operation for stress urinary incontinence in women
Author(s) -
Bodelsson Gunilla,
Henriksson Lars,
Osser Stellan,
Stjernquist Martin
Publication year - 2002
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.2002.01195.x
Subject(s) - medicine , urinary incontinence , surgery , sling (weapon) , urinary retention , spinal anesthesia , stress incontinence , neck of urinary bladder , urinary bladder
Objective To assess the prevalence of intra‐ and post‐operative complications with the tension free vaginal tape operation for female urinary incontinence. Design Non‐control case series. Setting University Hospital. Population One hundred and seventy‐seven operations on women who were diagnosed urodynamically to have genuine stress incontinence. In 26 cases (15%) there was symptomatic urge incontinence. Main outcome measures Intra‐ and post‐operative complications in relation to individual surgeons and mode of anaesthesia (local or spinal), and continence at short term follow up. Results Bladder or urethral perforation occurred in 26 cases (15%) and three operations were abandoned for these reasons. A failure to void after the first 24 hours was registered in 35 (20%); 21 (12%) had to undergo urethral dilatation while five patients (2.8%) had persistent urinary retention which required excision of the sling. These problems were significantly associated to the experience of surgeon. In seven cases (4%) haemorrhage required intravaginal tamponade. In three (1.7%) sling rejection occurred post‐operatively. When followed up six to eight weeks post‐operatively, 154 patients (88%) reported subjective cure, 21 (11%) significant improvement and two (1%) no improvement. The use of spinal anaesthesia increased the frequency of peroperative bladder perforation but affected neither the incidence of post‐operative bladder obstruction nor the outcome at follow up. Conclusions This study identifies short term complications which relate partly to the experience of the individual surgeon. Nevertheless the 88% subjective cure rate was independent of these factors.