Short term complications of the tension free vaginal tape operation for stress urinary incontinence in women.
OBJECTIVE
To assess the prevalence of intra- and post-operative complications with the tension free vaginal tape operation for female urinary incontinence.


METHODS
Non-control case series.


METHODS
University Hospital.


METHODS
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.


METHODS
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.
Bodelsson
Gunilla
G
Department of Obstetrics and Gynaecology, Malmö University Hospital, Sweden.
Henriksson
Lars
L
Osser
Stellan
S
Stjernquist
Martin
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D011126:Polypropylenes / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D013526:Surgical Mesh / Q000009:adverse effects; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014621:Vagina / Q000601:surgery*
D011126:Polypropylenes