title: [Approach and complications associated with suburethral synthetic slings in women: Systematic review and meta-analysis].
abstract: BACKGROUND
  We aim to assess the complications associated with different approaches used in female suburethral sling surgery.
  
  
  METHODS
  We performed a research on Medline using the following keywords: "suburethral slings", "complications", "safety" and "randomized". Only randomized clinical trials including women and reporting intra- and postoperative complications associated with the retropubic (RP) approach; TOT and/or TVT-O were included. The meta-analysis was conducted using the Review Manager (RevMan 5.3) software delivered by the "Cochrane Library".
  
  
  RESULTS
  Out of 176 articles, 23 were included in synthesis. Risks of bladder perforation during surgery (60/1482 vs 5/1479; OR=6.44; 95% CI [3.32-12.50]) and postoperative urinary retention (48/1160 vs 24/1159; OR=1.93; 95% CI [1.26-3.12]) were significantly higher with the RP approach, when compared with the transobturator (TO) approach (TOT or TVT-O). Conversely, the risk of prolonged postoperative pain was significantly lower after RP approach, when compared with TO approach (24/1156 vs 69/1149; OR=0.36; 95% CI [0.23-0.56]). Risks of intraoperative urethral injury, postoperative erosion and de novo overactive bladder were comparable between the two approaches. Data regarding the comparison between TOT and TVT-O were scarce and did not allow us to conclude about complications associated with.
  
  
  CONCLUSIONS
  The RP approach was associated with a significant risk of bladder perforation and postoperative urinary retention. The TO approach was associated with a higher risk of prolonged postoperative pain.
authors.affiliation: Service d'urologie, hôpital Claude-Huriez, CHU de Lille, université Lille-Nord-de-France, 1, rue Polonovski, 59000 Lille, France. Electronic address: biardeau.xavier@gmail.com.
authors.forename: X
authors.initials: X
authors.lastname: Biardeau
authors.affiliation: Service d'urologie, université Saint-Joseph, B.P. 17-5208, Mar Mickhaël Beyrouth, 1104-2020, Liban.
authors.forename: M
authors.initials: M
authors.lastname: Zanaty
authors.affiliation: Service d'urologie, institut Jules-Bordet, 121, boulevard de Waterloo, 1000 Bruxelles, Belgique.
authors.forename: F
authors.initials: F
authors.lastname: Aoun
authors.affiliation: Service d'urologie, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Benbouzid
authors.affiliation: Service d'urologie, CHU de Rennes, 2, rue Henri-le-Guilloux, 35033 Rennes, France.
authors.forename: B
authors.initials: B
authors.lastname: Peyronnet
mesh_terms: D005260:Female; D006801:Humans; D011183:Postoperative Complications / Q000209:etiology*; D019919:Prosthesis Implantation / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D053825:Suburethral Slings / Q000009:adverse effects*
keywords: Innocuité; Safety; Tension-free vaginal tape; Transobturator tape; Transobturator tension-free vaginal tape