Bladder perforation during tension-free vaginal tape surgery: does it matter?
OBJECTIVE
To analyze the incidence, possible risk factors, preoperative morbidity and outcome results in tension-free vaginal tape (TVT) cases complicated by lower urinary tract injury in a large, heterogeneous, consecutive group of women.


METHODS
Four hundred sixty consecutive women who underwent TVT surgery for correction of urodynamically proven stress urinary incontinence were enrolled prospectively. All the procedures were performed at 1 center by 3 experienced surgeons.


RESULTS
In this series, 3.9% cases of lower urinary tract injury occurred. Most of the injuries occurred during the learning curve. TVT-related urinary tract injury was not associated with increased perioperative morbidity. The cure rates were similar with and without injury. De novo urge and persistent urge incontinence were slightly more common in patients with bladder perforation.


CONCLUSIONS
Lower urinary tract injury during the TVT procedure is directly related to the inexperience of the surgeon. However, TVT-related lower urinary tract injury does not appear to affect medium-term outcome results.
Gold
Ronen S
RS
Urogynecology and Pelvic Floor Unit, Department of Obstetrics and Gynecology, LIS Maternity Hospital, Tel Aviv Sourasky Medical Center, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. r_gold_il@yahoo.com
Groutz
Asnat
A
Pauzner
David
D
Lessing
Joseph
J
Gordon
David
D
D000368:Aged; D002983:Clinical Competence; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects* / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D019300:Medical Errors / Q000009:adverse effects / Q000706:statistics & numerical data; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects; D011446:Prospective Studies; D053825:Suburethral Slings; D001743:Urinary Bladder / Q000293:injuries* / Q000601:surgery; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects* / Q000706:statistics & numerical data