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Complications of Mid Urethral Slings: Important Outcomes for Future Clinical Trials

2008; Lippincott Williams & Wilkins; Volume: 180; Issue: 5 Linguagem: Inglês

10.1016/j.juro.2008.07.029

1527-3792

Firouz Daneshgari, Wesley G. Kong, Mia A. Swartz,

Pelvic and Acetabular Injuries

No AccessJournal of UrologyReview Article1 Nov 2008Complications of Mid Urethral Slings: Important Outcomes for Future Clinical Trialsis accompanied byWhat Criteria Should Urologists Use When Choosing Surgery for Stress Urinary Incontinence? Firouz Daneshgari, Wesley Kong, and Mia Swartz Firouz DaneshgariFirouz Daneshgari Department of Urology and Female Pelvic Surgery, Upstate Medical University, Syracuse, New York , Wesley KongWesley Kong Glickman Urological and Kidney Institute, Lerner Research Institute, Cleveland, Ohio , and Mia SwartzMia Swartz Glickman Urological and Kidney Institute, Lerner Research Institute, Cleveland, Ohio View All Author Informationhttps://doi.org/10.1016/j.juro.2008.07.029AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Mid urethral slings are becoming the first line surgical treatment for stress urinary incontinence in women. We reviewed the complications of mid urethral sling placement and their potential pathophysiology. Materials and Methods: We conducted a literature search on MEDLINE® from 1995 to 2007 using the key words sling, complications, mid-urethral slings, transvaginal tape, transobturator tape, trials, pathophysiology and complications. The Cochrane database was also searched. The results were summarized according to the type of mid urethral slings reported. Results: There were 928 MEDLINE citations for sling and complications, 279 for sling and complications and bladder, and 68 for sling and complications and voiding dysfunction. The reported complication rates ranged from 4.3% to 75.1% for retropubic and 10.5% to 31.3% for transobturator mid urethral slings. Complications included bladder perforation, hemorrhage, bowel injury, vaginal extrusion, de novo urgency and urge incontinence, urinary tract infections and voiding dysfunction. Retropubic mid urethral slings led to a higher occurrence of complications such as bladder perforation and hematoma. In addition, the retropubic approach resulted in serious complications such as bowel injury, major vascular injury and death. Groin pain was more common after the transobturator approach. Experimental studies indicated that the potential mechanisms for sling complications may include vaginal dissection, denervation injury and bladder remodeling. Conclusions: Mid urethral slings result in bothersome complications which should not be minimized. Awareness of these complications should encourage improvements in patient counseling as well as further investigation of the underlying mechanisms. Decreasing complications should be considered an important outcome for future clinical studies of mid urethral slings. References 1 : Urinary incontinence in women. Lancet2006; 367: 57. 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Google Scholar © 2008 by American Urological AssociationFiguresReferencesRelatedDetailsCited byWein A (2020) Re: Long-Term Risk of Reoperation after Synthetic Mesh Midurethral Sling Surgery for Stress Urinary IncontinenceJournal of Urology, VOL. 203, NO. 6, (1066-1067), Online publication date: 1-Jun-2020.Dray E, Crosby E, Grable A, Crescenze I, Stoffel J, Clemens J and Cameron A (2019) A Retrospective Analysis of Surgical Outcomes and Risk Factors for Persistent Postoperative Symptoms Following Synthetic Mid Urethral Sling RevisionJournal of Urology, VOL. 202, NO. 2, (339-346), Online publication date: 1-Aug-2019.Milose J, Sharp K, He C, Stoffel J, Clemens J and Cameron A (2018) Success of Autologous Pubovaginal Sling after Failed Synthetic Mid Urethral SlingJournal of Urology, VOL. 193, NO. 3, (916-920), Online publication date: 1-Mar-2015.Hou J, Alhalabi F, Lemack G and Zimmern P (2018) Outcome of Transvaginal Mesh and Tape Removed for Pain OnlyJournal of Urology, VOL. 192, NO. 3, (856-860), Online publication date: 1-Sep-2014.Chermansky C, Krlin R and Winters J (2018) Selective Management of the Urethra at Time of Pelvic Organ Prolapse Repair: An Assessment of Postoperative Incontinence and Patient SatisfactionJournal of Urology, VOL. 187, NO. 6, (2144-2148), Online publication date: 1-Jun-2012.Greiman A and Kielb S (2018) Revisions of Mid Urethral Slings Can be Accomplished in the OfficeJournal of Urology, VOL. 188, NO. 1, (190-193), Online publication date: 1-Jul-2012.Related articlesJournal of Urology17 Sep 2008What Criteria Should Urologists Use When Choosing Surgery for Stress Urinary Incontinence? Volume 180Issue 5November 2008Page: 1890-1897 Advertisement Copyright & Permissions© 2008 by American Urological AssociationKeywordssuburethral slingsurinary incontinence, stressfemaleMetricsAuthor Information Firouz Daneshgari Department of Urology and Female Pelvic Surgery, Upstate Medical University, Syracuse, New York More articles by this author Wesley Kong Glickman Urological and Kidney Institute, Lerner Research Institute, Cleveland, Ohio More articles by this author Mia Swartz Glickman Urological and Kidney Institute, Lerner Research Institute, Cleveland, Ohio More articles by this author Expand All Advertisement PDF downloadLoading ...