Complications of tension-free vaginal tape surgery: a multi-institutional review

被引:234
作者
Abouassaly, R
Steinberg, JR
Lemieux, M
Marois, C
Gilchrist, LI
Bourque, JL
Tu, LM
Corcos, J
机构
[1] McGill Univ, Dept Urol, Montreal, PQ, Canada
[2] Hop Hotel Dieu, Arthabaska, PQ, Canada
[3] Verdun Hosp, Verdun, PQ, Canada
[4] Pierre Boucher Hosp, Longueuil, PQ, Canada
[5] LaSalle Hosp, La Salle, PQ, Canada
[6] Univ Sherbrooke Hosp Ctr, Sherbrooke, PQ, Canada
关键词
urinary incontinence; stress; tension-free vaginal tape; complications; urinary retention; bladder injury;
D O I
10.1111/j.1464-410X.2004.04910.x
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 [临床医学]; 100201 [内科学];
摘要
Objective To analyse the complications of tension-free vaginal tape (TVT) surgery, a minimally invasive alternative for treating patients with stress urinary incontinence (SUI), at six institutions, and to review the management of these complications and their effect on patient outcome. Patients and Methods In all, 241 patients who had a TVT procedure by six urologists at six hospitals (two university and four community) were reviewed retrospectively by the same urologist. Complications during and after surgery, and their management, were analysed. Results Complications during surgery included bladder perforation in 48 patients (5.8%) and blood loss > 500 mL in 16 (2.5%). Immediate complications after surgery were urinary retention (>24 h after) in 47 patients (19.7%), pelvic haematoma in four (1.9%) and suprapubic wound infection in one (0.4%). Of the 47 patients in retention, 32 were in retention for <48 h and treated with an indwelling catheter. The 15 remaining patients were treated with an indwelling catheter (one) or clean intermittent catheterization for a mean of 22 days. To correct the retention the TVT was released in seven patients and the tape sectioned in three. Late complications were de novo urgency, persistent suprapubic discomfort and intravaginal tape erosion in 36 (15%), 18 (7.5%) and one (0.4%) patient, respectively. Most of these complications resolved with observation and medical management, but intravaginal tape erosion required partial resection of the tape with closure and repair of the vaginal mucosa. Conclusions The present TVT complication rates were slightly higher than reported previously. This multi-institutional review in both academic and community hospitals may better reflect the morbidity of TVT insertion in clinical practice. TVT is a highly effective, minimally invasive method for treating SUI. A stricter definition of each complication and a better understanding of the mechanism of these complications may further improve the surgical outcome and decrease patient morbidity.
引用
收藏
页码:110 / 113
页数:4
相关论文
共 21 条
[2]
STRUCTURAL SUPPORT OF THE URETHRA AS IT RELATES TO STRESS URINARY-INCONTINENCE - THE HAMMOCK HYPOTHESIS [J].
DELANCEY, JOL .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1994, 170 (06) :1713-1723
[3]
Results of the tension-free vaginal tape procedure for the treatment of type II stress urinary incontinence at a minimum followup of 1 year [J].
Haab, F ;
Sananes, S ;
Amarenco, G ;
Ciofu, C ;
Uzan, S ;
Gattegno, B ;
Thibault, P .
JOURNAL OF UROLOGY, 2001, 165 (01) :159-162
[4]
Hunskaar S, 1999, INCONTINENCE, P197
[5]
Urinary retention after tension-free vaginal tape procedure: Incidence and treatment [J].
Klutke, C ;
Siegel, S ;
Carlin, B ;
Paszkiewicz, E ;
Kirkemo, A ;
Klutke, J .
UROLOGY, 2001, 58 (05) :697-701
[6]
The tension-free vaginal tape procedure: Correction of stress incontinence with minimal alteration in proximal urethral mobility [J].
Klutke, JJ ;
Carlin, BI ;
Klutke, CG .
UROLOGY, 2000, 55 (04) :512-514
[7]
A nationwide analysis of complications associated with the tension-free vaginal tape (TVT) procedure [J].
Kuuva, N ;
Nilsson, CG .
ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA, 2002, 81 (01) :72-77
[8]
Tension-free vaginal tape: Analysis of outcomes and complications in 404 stress incontinent women [J].
Meschia, M ;
Pifarotti, P ;
Bernasconi, F ;
Guercio, E ;
Maffiolini, M ;
Magatti, F ;
Spreafico, L .
INTERNATIONAL UROGYNECOLOGY JOURNAL, 2001, 12 (Suppl 2) :S24-S27
[9]
Tension-free vaginal tape for primary genuine stress incontinence: a two-centre follow-up study [J].
Moran, PA ;
Ward, KL ;
Johnson, D ;
Smirni, WE ;
Hilton, P ;
Bibby, J .
BJU INTERNATIONAL, 2000, 86 (01) :39-42
[10]
Long-term results of the tension-free vaginal tape (TVT) procedure for surgical treatment of female stress urinary incontinence [J].
Nilsson, CG ;
Kuuva, N ;
Falconer, C ;
Rezapour, M ;
Ulmsten, U .
INTERNATIONAL UROGYNECOLOGY JOURNAL, 2001, 12 (Suppl 2) :S5-S8