title: [Complications of female urinary incontinence surgery with mini-sling system].
abstract: OBJECTIVE
  To evaluate the complications of urinary incontinence (UI) surgery with mini-sling system. Describe its diagnosis and management.
  
  
  METHODS
  We make a descriptive analysis of the complications of the surgery in a group of 155 women with UI surgically treated with mini-sling system (50 TVT-Secur and 105 MiniArc) from October 2006 to November 2008. All patients were evaluated with clinical history, physical examination and two questionnaires of QoL (ICIQ-SF and EQ-5D). When urethral obstruction was suspected, we included urineculture, post-void residual urine measurement and urodynamics. The complications were grouped into three categories: intraoperatory, early (within de first month after surgery) and late complications (after a month). We use the SPSS program (V 14.0) for statistical analysis of the results.
  
  
  RESULTS
  The average age was 56 years (range 33-82) and 180 days for the following-up (range 26-817). We had a complication rate of 20% (22% TVT-Secur, 17% MiniArc). We reported one intraoperatory complication corresponding to a bladder perforation (0.64%), managed conservatively with catheterization. All early complications were reported in the MiniArc group: one obturator fossa hematoma (0.64%) spontaneously resolved, groin pain in 4 patients (2.5%) successfully treated with NSAIDs and one urethral obstruction (0.64%) that required mesh cutting. Late complications included: 8 vaginal erosions (5%), 4 required tape excision and vaginal wall closure; 2 were treated with vaginal estrogens, and the other 2 were asymptomatic so we did nothing. 6 patients (3.8%) showed urethral obstruction: we performed mesh cutting in 5, whereas one patient improved with intermittent catheterization. Urge symptoms were reported in 10 patients (6.45%) and successfully managed with anticholinergic agents. 2 patients suffered from recurrent infections (1.3%) confirmed by antibiogram, treating isolated episodes.
  
  
  CONCLUSIONS
  Urinary incontinence surgery with mini-sling system is not free of complications (20%). Most of them are mild and can be successfully treated conservatively.
authors.affiliation: Servicio de Urología, Hospital Virgen del Camino, Pamplona, Navarra, España. silvia81mdc@hotmail.com
authors.forename: S
authors.initials: S
authors.lastname: Alvarez-Bandrés
authors.forename: A
authors.initials: A
authors.lastname: Hualde-Alfaro
authors.forename: J
authors.initials: J
authors.lastname: Jiménez-Calvo
authors.forename: J L
authors.initials: JL
authors.lastname: Cebrián-Lostal
authors.forename: J D
authors.initials: JD
authors.lastname: Jiménez-Parra
authors.forename: D
authors.initials: D
authors.lastname: García-García
authors.forename: M
authors.initials: M
authors.lastname: Montesino-Semper
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011474:Prosthesis Design; D012189:Retrospective Studies; D053825:Suburethral Slings / Q000009:adverse effects*; D013997:Time Factors; D014549:Urinary Incontinence / Q000601:surgery*