A retrospective analysis of perioperative complications associated with retropubic tension-free vaginal tape in 960 women

Abstract

Purpose The purpose is to analyse perioperative complications associated with the retropubic tension-free vaginal tape (TVT) procedure and their management. Methods This retrospective, monocentric cohort study included 960 women after retropubic TVT procedure performed by one surgeon from 2011 to 2016. Complications were identified up to 6 weeks after the procedure, divided into specific and general complications and classified based on the Clavien–Dindo (CD) Classification. A visit 6 weeks after the surgical procedure was attended by all patients. Results 77 complications, of which 74 occurred postoperatively and 3 intraoperatively, affecting 72 (7.5%) out of 960 women. Urinary retention and voiding problems were the most common complication. The mean age of women suffering complications was 3.4 years higher in comparison to the mean age of women without complications (p = 0.036). The Body Mass Index (BMI) of the group of women with perioperative complications had an average BMI which was 0.5 kg/m2 lower than the average BMI of the women without complications. 22 (12.8%) out of 172 women with recurrent stress incontinence had postoperative complications, of which 21 were related to the TVT. Conclusion The retropubic TVT is a surgical procedure associated with a low number of perioperative complications, even in the group of elderly and overweight women, as well as in cases of recurrent stress incontinence.

The Transobturator Tape Versus Retropubic Tension-Free Vaginal Tape in the Treatment of Comorbid and Elderly Women With Stress Urinary Incontinence: A Retrospective Analysis of Over 800 Women

“…It is well-known that urinary retention and voiding dysfunction are the most common complications following the MUS procedure [12,13], which is in line with the data presented in this study. The higher incidence of postoperative voiding dysfunction in our cohort compared to the literature [4,12] might be attributed to a standardized and precise postoperative control via transvaginal ultrasound.…”

“…While the incidence of postoperative voiding dysfunction was higher than in the literature, only 1.3% of our patients required revision surgery with tape mobilization. This is lower compared to the studies of Barisiene et al and Jahn et al, which showed rates of 2.4-3.5% [12,13].…”

“…Studies have offered conflicting findings in this regard so far. On the one hand, there are studies demonstrating that a higher BMI has no influence on the complication rate of MUS [ 15 , 16 ], while on the other, there are studies showing a rising complication rate with a higher BMI [ 13 , 17 ]. This finding can be attributed to the selection bias.…”

“…However, other studies have reported conflicting results. Some studies have described increased complication rates in elderly patients with a higher incidence of bladder perforations and a higher number of voiding difficulties after surgery [ 7 , 13 , 18 - 19 ]. However, the study by Stav et al found comparable complication rates in younger and older women with no increased risk, especially for severe events [ 10 ].…”

Impact on urinary incontinence after management of complications related to a retropubic midurethral sling

“…The MUS is a safe procedure, but does have some potential complications, both intra- and postoperatively [ 2 , 7 ]. The most common complications are urgency, hematomas, bleeding, postoperative urinary retention (POUR), infections, and vaginal MUS exposure [ 8 ].…”