Sling techniques are the method of choice in stress urinary incontinence management, despite the high rates of complications leading sometimes to the necessity of re-operation, and the tape transection and resection are of the greatest importance.
The study was aimed at analyzing the indications, technique and effects of transvaginal tape excision.
A retrospective study including 100 patients who underwent surgical removal of the sub-urethral sling in Evangelisches Krankenhaus Hagen-Haspe was conducted. The analyzed measures were: sling type, onset of symptoms, rates of particular complications, safety and outcome of the operative procedure.
Most complications occurred in the first 2 years after surgery. The most common indications for re-operation were: overactive bladder (OAB) (64%), persistent stress urinary incontinence (SUI) (59%), pain (40%), urinary retention (40%), and erosion (29%). Some of the complications co-existed (i. e. vaginal erosion with postoperative pain, infections with urinary retention). During the procedure 1 bladder was injured and 1 patient had a hematoma. In women with OAB, 24-hour frequency decreased from 13. 3 to 8. 5 (p < 0. 001), the mean voiding volume increased from 131. 7 to 216. 4 ml (p < 0. 001), and nocturia increased from 3. 28 to 1. 19 (p < 0. 001). Intensity of urgency decreased from 8. 78 to 0. 92 in the 10-point visual score (p < 0. 001). Pain and urinary retention resolved in 39 out of 40 patients (p < 0. 0001). The rate of SUI increased from 59% to 83% (p < 0. 001).
Sling removal is safe and associated with a minimal rate of complications. Removing the tape causes resolution of most of the complications, but SUI recurs or worsens.
Archives of medical science : AMS. 2015 Oct 12 [Epub]
George Fabian, Jacek Kociszewski, Andrzej Kuszka, Margarethe Fabian, Susane Grothey, Aneta Zwierzchowska, Wojciech Majkusiak, Ewa Barcz
Department of Gynecology and Obstetrics, Evangelisches Krankenhaus Hagen-Haspe, Hagen, Gemany. , Department of Gynecology and Obstetrics, Evangelisches Krankenhaus Hagen-Haspe, Hagen, Gemany. , Department of Gynecology and Obstetrics, Evangelisches Krankenhaus Hagen-Haspe, Hagen, Gemany. , Department of Gynecology and Obstetrics, Evangelisches Krankenhaus Hagen-Haspe, Hagen, Gemany. , Department of Gynecology and Obstetrics, Evangelisches Krankenhaus Hagen-Haspe, Hagen, Gemany. , I Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland. , I Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland. , I Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland.