Risk factors influencing the complication rates of tension-free vaginal tape-type procedures.
OBJECTIVE
Tension-free vaginal tape (TVT)-type procedures are gradually becoming the new gold-standard treatment for female stress urinary incontinence. Studies trying to determine the influence of possible risk factors on complications of TVT surgery are needed in order to achieve more favorable results in the future. This review attempts to summarize the current studies which address the possible risk factors influencing the complication rates of TVT-type procedures.


RESULTS
Articles published in 2004 and 2005 were included and focused, while the older articles were used for historical purposes and achieving the integrity. Risk factors stated in the literature for immediate, infectious, vaginal and urethral erosion complications are found to be mostly on anectodal and speculative bases. The role of concomitant surgery as a risk factor for complications is conflicting, while preoperative low urine flow and low detrusor contractility for urinary retention, and previous anti-incontinence surgery and old age for de-novo urgency seem to appear as possible risk factors.


CONCLUSIONS
Most of the risk factors stated were anecdotal and speculative. No consensus exists on concomitant surgery's being a risk factor for postoperative urinary retention and bladder perforation, while prior anti-incontinence surgery and old age were found to be possible risk factors for postoperative overactive bladder symptoms. Multicentric data collection with well designed parameters under the surveillance of a well known organization is needed in order to identify the risk factors influencing the complications of TVT-type procedures.
Cetinel
Bulent
B
Department of Urology, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey. sulecet@superonline.com
Demirkesen
Oktay
O
D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D011183:Postoperative Complications / Q000453:epidemiology*; D012307:Risk Factors; D014522:Urethral Diseases / Q000209:etiology; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D016055:Urinary Retention / Q000209:etiology; D014621:Vagina / Q000601:surgery; D014623:Vaginal Diseases / Q000209:etiology