title: Complications of mid-urethral slings for treatment of stress urinary incontinence.
abstract: OBJECTIVE
  To compare the incidence of complications associated with the use of retropubic tension-free vaginal tape (TVT) and transobturator tension-free vaginal tape (TVT-O) for the management of stress urinary incontinence (SUI).
  
  
  METHODS
  In a cross-sectional study, 1081 patients were treated for SUI via mid-urethral slings, and the outcomes of those treated via TVT and those treated via TVT-O were compared. Patients who suffered from recurrent or mixed urinary incontinence were excluded.
  
  
  RESULTS
  Group 1 included patients treated via TVT (n=207) and group 2 included those treated with TVT-O (n=570). There was a higher incidence of bladder perforation (5.4% versus 0.6%; P=0.001) and hematoma formation (9.1% versus 1.5%; P=0.001) in group 1 than in group 2. Compared with group 1, there was higher incidence of vaginal wall perforation in group 2 (0.0% versus 3.8%, P=0.044). The rate of intraoperative complications was not related to patient age, body mass index, or parity. Of the patients who did not leak urine during a cough test 1 month after surgery, 90.9% still had a negative cough test at the long-term follow-up.
  
  
  CONCLUSIONS
  TVT-O was superior to TVT with regard to the incidence of bladder perforation and hematoma formation, but it resulted in more vaginal wall injuries.
authors.affiliation: Moscow State University of Medicine and Dentistry, 127206, Vucheticha 21, Moscow, Russia.
authors.forename: Dmitry Y
authors.initials: DY
authors.lastname: Pushkar
authors.forename: Boris N
authors.initials: BN
authors.lastname: Godunov
authors.forename: Michail
authors.initials: M
authors.lastname: Gvozdev
authors.forename: Gevorg R
authors.initials: GR
authors.lastname: Kasyan
mesh_terms: D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006406:Hematoma / Q000209:etiology; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D012307:Risk Factors; D053825:Suburethral Slings / Q000009:adverse effects*; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000293:injuries; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014621:Vagina / Q000293:injuries