scholarly journals Minimally Invasive Surgery for Stress Urinary Incontinence – Mesh Complications

PRILOZI ◽  
2014 ◽  
Vol 35 (2) ◽  
pp. 105-110
Author(s):  
Vasil N. Iliev ◽  
Irena T. Andonova

Abstract Currently, the most commonly performed surgeries for stress urinary incontinence (SUI) are mesh midurethral slings (MUS). They are minimally invasive outpatient procedures, and they are as effect-tive as traditional suburethral slings, open retropubic colposuspension (Burch, Marshall-Marchetti), and laparoscopic retropubic colposuspension. They have a short operative time and fewer postoperative complications. In the paper we present results from a prospective study of 214 patients with SUI who underwent midurethral sling placement: 68 patients with retropubic slings (TVT) and 146 patients with transobturator slings (TVT-O) followed over 12 months. The operations were performed at the Department of Obstetrics and Gynaecology at the Medical Faculty, Skopje, R. Macedonia and at the Department of Obstetrics and Gynaecology, General Hospital, Sibenik, Croatia. All MUS placements (TVT and TVT-O) were performed by one surgeon (urogynaecologist) using the standard surgical technique and operative and postoperative protocol for those procedures. TVT and TVT-O meshes are polypropylene macroporous meshes produced by “Ethicon” We evaluated mesh complications related to the procedure (Table 1) and complications specific to the mesh (Table 2). In the article are presented the data from up-to-date literature related to the evaluated topic parallel to our results. We can conclude that all our findings on the evaluated groups are comparable with the data from competent literature. Instead of a conclusion we would like to suggest continuous follow-up of all minimally invasive procedures with midurethral slings placement for collecting experience of side-effects and complications and improving those procedures which are gold standard today in the treatment of SUI.

Author(s):  
Letícia Oliveira ◽  
Marcia Dias ◽  
Sérgio Martins ◽  
Jorge Haddad ◽  
Manoel Girão ◽  
...  

Objective To compare surgical treatments for stress urinary incontinence in terms of efficiency and complications. Data Sources We searched the MEDLINE and COCHRANE databases using the terms stress urinary incontinence, surgical treatment for stress urinary incontinence and sling. Selection of Studies Forty-eight studies were selected, which amounted to a total of 6,881 patients with scores equal to or higher than 3 in the Jadad scale. Data Collection Each study was read by one of the authors, added to a standardized table and checked by a second author. We extracted data on intervention details, follow-up time, the results of treatment and adverse events. Data Synthesis Comparing retropubic versus transobturator slings, the former was superior for both objective (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.05–1.54) and subjective (OR, 1.23; 95% CI, 1.02–1.48) cures. Between minislings versus other slings, there was a difference favoring other slings for subjective cure (OR, 0.58; 95% CI, 0.39–0.86). Between pubovaginal sling versus Burch surgery, there was a difference for both objective (OR, 2.04; 95% CI, 1.50–2.77) and subjective (OR, 1.64; 95% CI, 1.10–2.44) cures, favoring pubovaginal sling. There was no difference in the groups: midurethral slings versus Burch, pubovaginal sling versus midurethral slings, transobturator slings, minislings versus other slings (objective cure). Retropubic and pubovaginal slings are more retentionist. Retropubic slings have more bladder perforation, and transobturator slings, more leg and groin pain, neurological lesion and vaginal perforation. Conclusion Pubovaginal slings are superior to Burch colposuspension surgery but exhibit more retention. Retropubic slings are superior to transobturator slings, with more adverse events. Other slings are superior to minislings in the subjective aspect. There was no difference in the comparisons between midurethral slings versus Burch colposuspension surgery, pubovaginal versus midurethral slings, and inside-out versus outside-in transobturator slings.


2014 ◽  
Vol 123 ◽  
pp. 197S-198S ◽  
Author(s):  
Emanuel C. Trabuco ◽  
Daniel A. Carranza ◽  
Sherif A. El-Nashar ◽  
Christopher J. Klingele ◽  
John B. Gebhart

2009 ◽  
Vol 9 ◽  
pp. 466-478 ◽  
Author(s):  
Simone Crivellaro ◽  
John J. Smith

The aim of this review is to provide an update on the current status of evolving minimally invasive therapies for stress urinary incontinence. Bioinjectables have been available for some time and their current status is reviewed. The adjustable continence device has been used as a salvage procedure for females for a number of years in clinical trials, yet many are unfamiliar with it. Lastly, radiofrequency via a transurethral route has also been utilized in small numbers and will be updated. These later two emerging technologies need further exposure to better define their role in our clinical practice.


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