title: [Urinary complications in sub-urethral sling procedures].
abstract: BACKGROUND
  Urinary complications following sub urethral sling procedures are common, and management of these complications continue to be discussed.
  
  
  METHODS
  The literature available on Medline/PubMed, relating to urinary complications associated with suburethral sling procedures, was reviewed.
  
  
  RESULTS
  Bladder perforation, which occurs with an incidence of 5.7% in tension-free vaginal tape procedure, requires repositioning of the sling, but does not cause any increase in postoperative morbidity. The trans-obturator approach appears to decrease this risk. Urethral perforation, which is uncommon (0.4-1%), is a contraindication to maintenance of the sling. Bladder erosion is rare, requiring resection of the mesh with a combined abdominal and cystoscopic approach. Urethral mesh erosion (0.07% to 1.5%) also requires surgical sling removal, but few patients remain continent because this removal requires a large urethrolysis (recurrence rate of incontinence is 66% following removal of the sling). Bladder outlet obstruction occurs frequently after sub-urethral procedures. When complete obstruction is clinically evident 2 days after a sub-urethral sling procedure, immediate reintervention is performed with a rapid return to normal voiding. Recurrence rate of stress incontinence is less than 30% following reintervention.
authors.affiliation: Service de Gynécologie-Obstétrique, Hôpital Antoine-Béclère, Clamart. x.deffieux@free.fr
authors.forename: X
authors.initials: X
authors.lastname: Deffieux
authors.forename: K
authors.initials: K
authors.lastname: Bonnet
authors.forename: N
authors.initials: N
authors.lastname: Chevalier
authors.forename: A
authors.initials: A
authors.lastname: Gervaise
authors.forename: R
authors.initials: R
authors.lastname: Frydman
authors.forename: H
authors.initials: H
authors.lastname: Fernandez
mesh_terms: D004868:Equipment Failure; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D016239:MEDLINE; D011183:Postoperative Complications / Q000453:epidemiology; D012008:Recurrence; D013526:Surgical Mesh; D014521:Urethra; D001743:Urinary Bladder / Q000293:injuries; D001745:Urinary Bladder Diseases / Q000453:epidemiology / Q000209:etiology; D001748:Urinary Bladder Neck Obstruction / Q000453:epidemiology / Q000209:etiology; D014549:Urinary Incontinence / Q000601:surgery*; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000209:etiology; D014570:Urologic Diseases / Q000453:epidemiology* / Q000209:etiology; D013520:Urologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods