Prospective analysis of complications of tension-free vaginal tape from The Netherlands Tension-free Vaginal Tape study.
OBJECTIVE
The intra- and postoperative anatomic complications, frequency, and influence of risk factors of the tension-free vaginal tape are described.


METHODS
This was a prospective cohort study of 809 patients.


RESULTS
The total intraoperative complication rate was 6.2%. Previous prolapse surgery was a risk factor for complications (odds ratio, 2.86; 95% CI, 1.15-7.11). We found more intraoperative complications in patients with general anesthesia than with local analgesia with sedation (odds ratio, 4.14; 95% CI, 2.01-8.53). In teaching hospitals the postoperative complication frequency was higher than in non-teaching hospitals (odds ratio, 0.55; 95% CI, 0.35-0.85). The learning curve is short, and more postoperative complications were found in the second 10 patients who underwent operation by 1 surgeon (odds ratio, 1.94; 95% CI, 1.14- 3.29). Spinal analgesia gives fewer postoperative complications than local analgesia with sedation (odds ratio, 0.35; 95% CI, 0.13- 0.92).


CONCLUSIONS
Tension-free vaginal tape is a relative safe procedure; concomitant pelvic surgery can be performed safely. Several risk factors for complications were identified: menopausal state, previous prolapse surgery, mode of anesthesia, teaching hospital, and the second ten procedures of each surgeon.
Schraffordt Koops
Steven E
SE
Department of Gynecology and Obstetrics, Meander Medical Centre, Amersfoort, The Netherlands. schraff@zonnet.nl
Bisseling
Tanya M
TM
Heintz
A Peter M
AP
Vervest
Harry A M
HA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000698:Analgesia / Q000379:methods; D000768:Anesthesia, General; D015331:Cohort Studies; D005260:Female; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000453:epidemiology; D008499:Medical Records; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects* / Q000295:instrumentation*; D009426:Netherlands; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D013526:Surgical Mesh / Q000009:adverse effects; D014014:Tissue Adhesives / Q000009:adverse effects; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects* / Q000295:instrumentation*; D014621:Vagina
D014014:Tissue Adhesives