Intraoperative and postoperative complications of tension-free midurethral slings in stress urinary incontinence
DOI:
https://doi.org/10.48193/revistamexicanadeurologa.v79i3.465Keywords:
Complications, retropubic, transobturator, stress urinary incontinence, urinary tract infectionAbstract
Background: Midurethral slings are one of the first-line surgical treatments for stress urinary incontinence. The aim of the present study was to evaluate the intraoperative and postoperative complications of retropubic and transobturator midurethral slings and the associated risk factors.
Material and methods: A retrospective case series was conducted on 105 women within the time frame of 2016 to 2018. The women were divided into 2 groups: those that underwent retropubic sling placement (n=28) and those that underwent transobturator sling placement (n=77). Demographic variables, risk factors, intraoperative complications, and postoperative complications were analyzed. Descriptive statistics and correlations between variables were performed utilizing the SPSS version 17.0 program and statistical significance was set at a p ≤ 0.05.
Results: Mean patient age was 56.7 ± 8.8 years. A total of 31.4% (n=33) of the patients presented with stress incontinence, 65.7% (n=69) with mixed incontinence, and 2.9% (n=3) with occult stress incontinence. The overall complication rate was 29.5% (n=31). The most common intraoperative complication was bladder perforation in 3.8% of the retropubic group patients and was associated with obesity (odds ratio:12.9). The postoperative complications were related to the transobturator sling (p=0.049) and included urinary tract infection (11.4%), inguinal pain (7.6%), and others (6.9%). The risk for postoperative urinary infection was associated with stress incontinence (p=0.03) and the absence of treatment for mixed urinary incontinence (p=0.04), increasing the postoperative urge urinary incontinence rate.
Conclusions: The intraoperative complication rates with the transobturator approach were low, compared with the retropubic approach. The most common complication in our case series was urinary tract infection, showing the need for randomized prospective studies to be conducted.
