Risk Factors for Intraoperative Bladder Perforation at the Time of Midurethral Sling Placement

Kuhlmann, Paige; Dallas, Kai; Masterson, John M.; Patel, Devin; Chen, Andrew; Castaneda, Peris; Ackerman, A. Lenore; Anger, Jennifer T.; Eilber, Karyn S.

doi:10.1016/j.urology.2020.11.023

Cited by 6 publications

(2 citation statements)

References 15 publications

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“…A limited number of publications have studied Safyre™ and all of them used a transobturator approach, with bladder perforation rates varying between 0 -4.2% (1,9,10). Risk factors for bladder injury in this context may include previous pelvic surgeries (cesarean section, colposuspension, rectocele), inexperienced surgeons, local anesthesia, younger patient age and lower body mass index (BMI) (4,20). In the current study, previous surgeries and BMI were similar in both groups.…”

Section: Discussionmentioning

confidence: 61%

Incontinence outcomes in women undergoing retropubic mid-urethral sling: a retrospective cohort study comparing Safyre™ and handmade sling

et al. 2022

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Purpose: This study examined and compared efficacy, safety, satisfaction, and complications of the retropubic Safyre™ sling and a retropubic hand-made synthetic sling (HMS) in a short-, mid-and long-term follow-up. Methods: We retrospectively reviewed a prospectively maintained database of women who underwent Safyre™ or HMS between March 7 ths 2005 and December 27 ths , 2017. Patients had first assessment (7-10 days), second (40-45 days), and third (sixth month) postoperatively. Between September and December 2018, patients who completed at least one year of surgery, received a telephone call. Follow-up compared quartiles of follow-up time to determine complications (Clavien-Dindo), success rates (International Consultation on Incontinence Modular Questionnaire for Urinary Incontinence Short Form -ICIQ-UI SF), and patient satisfaction. Results: Three hundred fifty-one patients underwent surgery and 221 (63%) were evaluated after a median of 78.47 (± 38.69) months, 125 (55%) in the HMS, and 96 (45%) in the Safyre™ group. Higher intraoperative bladder injury was observed with Safyre™ (0% vs. 4.2%, p=0.034), and a tendency for urinary retention, requiring indwelling urinary catheter over 24 hours (2.4% vs. 8.3%, p=0.061). Both HMS (p<0.001) and Safyre™ (p<0.001) presented improvements on ICIQ-UI SF. There were no differences in satisfaction, subjective cure rates, ICIQ-UI SF, or complications between groups. Conclusions: Both HMS and Safyre™ have similar satisfaction and subjective cure rates, with marked ICIQ-UI SF score improvement. Higher rates of intraoperative bladder injury were seen in patients who received Safyre™ retropubic sling.

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Section: Discussionmentioning

confidence: 61%

Incontinence outcomes in women undergoing retropubic mid-urethral sling: a retrospective cohort study comparing Safyre™ and handmade sling

et al. 2022

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“…Predisposing factors for bladder perforation are surgeons' lack of experience, cystocele, advanced age, smoking, diabetes mellitus, low body mass index, previous vaginal, or pelvic surgery. [ 10 11 ] Our case has diabetes mellitus and a previous history of vaginal repair. Cystoscopy must be done more carefully and obsessively for cases with predisposing factors.…”

Section: Discussionmentioning

confidence: 99%

Labial Cellulitis and Suprapubic Urine Leakage after Midurethral Sling

Saberi

Zargham

Hayrabedian

2021

Advanced Biomedical Research

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Retropubic midurethral sling (MUS) is safe and effective surgery used for the treatment of stress urinary incontinence in women. Bladder neck perforation is a rare intraoperative complication. If this complication missed in intraoperative cystoscopy may have serious morbidity. A 52-year-old woman underwent a retropubic MUS. She presented with early and unusual symptoms such as suprapubic and labial cellulitis and urine leakage through the suprapubic incision 1 week after surgery which was due to a missed bladder neck perforation during surgery. In cystoscopy after MUS revealed mesh traversing the bladder neck and it was removed. The missed bladder perforation may have early and unusual symptoms and cystoscopy must be done more carefully and obsessively in patients with risk factors.

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Does trocar puncture of the bladder during midurethral sling impact postoperative urinary storage and voiding symptoms?

et al. 2023

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Risk Factors for Intraoperative Bladder Perforation at the Time of Midurethral Sling Placement

Cited by 6 publications

References 15 publications

Incontinence outcomes in women undergoing retropubic mid-urethral sling: a retrospective cohort study comparing Safyre™ and handmade sling

Incontinence outcomes in women undergoing retropubic mid-urethral sling: a retrospective cohort study comparing Safyre™ and handmade sling

Labial Cellulitis and Suprapubic Urine Leakage after Midurethral Sling

Does trocar puncture of the bladder during midurethral sling impact postoperative urinary storage and voiding symptoms?

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