Complications of the tension-free vaginal tape procedure for stress urinary incontinence.
OBJECTIVE
The purpose of the study was to determine the intraoperative and immediate postoperative complications of tension-free vaginal tapes (TVTs) and risk factors contributing to these.


METHODS
The study was a retrospective cohort study of 778 TVT procedures.


RESULTS
The intraoperative and postoperative complications from the study are as follows: Intraoperative complications included bladder perforation (6.6%), blood loss requiring transfusion (0.6%), and laparotomy (0.1%). Postoperatively, 3.1% of patients developed UTI, while 56.0% had difficulty voiding, and 16.6% had retention. Upon discharge, 54.8% of patients voided, 34.3% self-catheterized, and 8.0% had indwelling catheters. Surgeons responsible for more than 100 TVT procedures had one third the odds of a bladder perforation. Previous incontinence or prolapse surgery were risk factors for bladder perforation. Women with voiding dysfunction preoperatively had a 1.80-fold odds of difficulty postoperatively.


CONCLUSIONS
Bladder perforation and postoperative retention are the most common complications of TVTs. Risk factors for perforation include less frequent TVT performance and previous prolapse, or incontinence surgery. Preexisting voiding dysfunction leads to postoperative retention.
Kristensen
Ingrid
I
Department of Obstetrics and Gynecology, University of Calgary, 4th Floor, North Tower, Foothills Medical Centre, 1441 29th Street NW, Calgary, AB T2N 4J8, Canada. Ingrid.kristensen@albertahealthservices.ca
Eldoma
Maysoon
M
Williamson
Tyler
T
Wood
Stephen
S
Mainprize
Tom
T
Ross
Sue
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D053825:Suburethral Slings / Q000009:adverse effects*; D014550:Urinary Incontinence, Stress / Q000601:surgery*