OBJECTIVE: Evaluation of the diagnostic and therapeutic management of erosive complications after mid urethral sling (MUS) procedure: vaginal erosions (VE), bladder (BE) and urethral (UE).
METHODS: Retrospective monocentric study concerning cohort of patients undergoingsurgery from January 2002 to January 2013 supported for erosive complications of MSU: TVT (Tension-free Vaginal Tape) or TOT (Trans-Obturateur Tape).
RESULTS: Sixteen patients were diagnosed for erosive complications: 7 VE, 6 BE and 3 UE. Dyspareunia and vaginal discharge were observed in 86% patients (n=6/7) with VE. Conservative treatment by vaginal approach was systematically performed in cases of vaginal erosion. After removal of material, 100% dyspareunia were corrected. Postoperative continence was maintained in 57% of patients (n=4/7). Urinary infection was the main symptom of patients with BE. Severe dysuria was present in 66% of patients with a UE (n=2/3). First-line therapy by endoscopic treatment was performed in 77% of patients (n=7/9) with a BE or UE. A second surgery was required in 42% of patients treated with endoscopic first-line therapy (n=3/7) because of a new exposure of MUS. Three of nine patients recurred their incontinence after first-line therapy (33%).
CONCLUSION: The removal of device exposed vaginally in case VE systematically corrected symptoms with about 60% of continence. In case of BE or UE, endoscopic treatment in first-line therapy was rarely definitive (42%) and recurrence of incontinence appeared in 30% cases.
Written by:
Forzini T, Viart L, Alezra E, Saint F. Are you the author?
Service d'urologie-transplantation, CHU Amiens-Picardie, avenue Laënnec, 80480 Salouël, France; Laboratoire de recherche HeRVI (EA 3801), CURS-CHU Amiens-Picardie, 150, avenue de la Croix-Jourdain, 80480 Salouël, France; Laboratoire d'anatomie et d'organogénèse, UFR de médecine d'Amiens, 3, rue des Louvels, 80036 Amiens cedex 1, France.
Reference: Prog Urol. 2015 Jan 20. pii: S1166-7087(14)00694-0.
doi: 10.1016/j.purol.2014.12.007
PubMed Abstract
PMID: 25617074
Article in French.