Placement of a mid-urethral sling is the gold standard in the surgical management of stress urinary incontinence in women in France. The cure rate of this material is no longer to be demonstrated, but the per- and post-operative complications are currently the subject of a growing controversy not only in Europe but also across the Channel and across the Atlantic, having led to the modification of operative indications. In France, recommendations are also evolving with a stricter framework for indications for surgery by multidisciplinary consultation meeting and an obligation for postoperative follow-up in the short and long term.
In this context, CUROPF realized a review of the literature bringing together the available scientific evidence concerning the occurrence of per- and post-operative complications relating to the installation of mid urethral sling. The bibliographic search was carried out using the Medline database and 123 articles were selected.
Analysis of the data highlights various complications, depending on the implanted material, the patient and the indication for surgery. The retro-pubic mid urethral sling provides more bladder erosion during surgery (up to 14%), more suprapubic pain (up to 4%) and more acute urinary retention (up to 19,7%) and postoperative dysuria (up to 26%). The trans obturator mid-urethral sling is responsible for more vaginal erosion during the operation (up to 10,9%), more lower limb pain of neurological origin (up to 26,7%). The risk of developing over active bladder is similar in both procedures (up to 33%). But these risks of complications must be balanced by the strong impact of urinary incontinence surgery on the overall quality of life of these women.
Thus, surgical failure and long term complications exist but should not limit the surgical management of stress urinary incontinence with mid urethral tape. Women should be treated with individualized decision-making process and long-term follow -up is necessary.
Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie. 2021 Nov 15 [Epub]
L Even, B Tibi, I Bentellis, P J Treacy, N Berrogain, P O Bosset, S Campagne-Loiseau, V Cardot, T Charles, X Deffieux, L Donon, F Girard, J-F Hermieu, S Hurel, J Klap, F Meyer, L Peyrat, C Thuillier, A Vidart, L Wagner, J N Cornu
Cabinet d'urologie, espace santé 3 83500 La Seyne sur Mer, clinique du Cap d'Or, 83500 La Seyne sur mer, Polyclinique Les Fleurs, 83190 Ollioules, France., Service d'urologie, université de Nice-Sophia Antipolis, hôpital Pasteur 2, CHU de Nice, 06000 Nice, France., Clinique Ambroise-Paré, 31100 Toulouse, France., Service d'urologie, hôpital Foch, 40, rue Worth, 92150 Suresnes, France., Service de gynécologie-obstétrique, CHU Estaing, Clermont-Ferrand, France., Clinique de Meudon-Clamart, 3, avenue de Villacoublay, 92360 Meudon, France., Service d'urologie, CHU La Miletrie, 86000 Poitiers, France., Service de gynécologie-obstétrique, hôpital Antoine-Béclère (AP-HP), 92140 Clamart, France., Clinique de la Côte Basque, 64100 Bayonne, France., Service d'urologie, clinique Oudinot Fondation Cognac-Jay, 2, rue Rousselet, 75007 Paris, France., Service d'urologie, hôpital Bichat, AP-HP, Paris, France., Service d'urologie, hôpital européen Georges-Pompidou, AP-HP, Paris, France., Service d'urologie, hôpital Privé Claude Galien, 91480 Quincy-sous-Sénart, France., Service d'urologie, hôpital Saint-Louis, AP-HP, Paris, France., Service d'urologie, clinique Turin, 75008 Paris, France., Service d'urologie, CHU Grenoble-Alpes, 38000 Grenoble, France., Service d'urologie, CHU de Nîmes, place du Pr-Robert-Debré, 30029 Nîmes cedex 9, France., Service d'urologie, université de Rouen, hôpital Charles-Nicolle, 1, rue de Germont, 76000 Rouen, France. Electronic address: .