Management of mid-urethral tape complications: a retrospective study
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Background/purpose of the study
Following mid-urethral tape insertion, for stress urinary incontinence (SUI), a proportion of women experience complications such as voiding dysfunction or tape erosion which fail to respond to conservative management approaches. These women thus require further surgical treatment. Our objective was to describe the outcomes of the surgical management of complications in these women.
This retrospective study describes the results obtained following the surgical management of mid-urethral tape complications. Twenty-nine consecutive women who required mid-urethral tape lysis, loosening or excision for tape-related complications in the period 2007–2017 were included. Primary outcomes were improvement in voiding dysfunction and resolution of pain, while secondary outcomes were evaluation of the recurrence of stress urinary incontinence and patient satisfaction. Patient outcomes were measured using the Patient Global Impression of Improvement questionnaire.
There were 1459 mid-urethral tape procedures performed in the study period. Twenty-nine women (1.99%) who had revision surgery for tape complication were identified. Interventions included tape loosening or lysis in 19 women and tape excision in ten women. Twenty-three of the 29 patients reported a significant improvement in their symptoms postoperatively. Two women had a recurrence of SUI in the tape excision cohort; all patients following tape loosening or lysis remained continent.
Tape revision surgery is a safe and effective treatment for mid-urethral tape complications with the majority of women maintaining continence following revision. Early intervention and proactive management of complications, by the appropriate specialist, will improve outcomes.
KeywordsVoiding dysfunction Mid-urethral tape procedure Stress urinary incontinence Tape exposure
The authors would like to acknowledge Dr. Suzana Matias, who assisted with the tape lysis data. Dr. Ifeoma Offiah is a NIHR Clinical Lecturer and is thus sponsored by NIHR.
Compliance with ethical standards
Conflict of interest
Ifeoma Offiah, Suneetha Rachaneni and Anupreet Dua declare that they have no conflict of interest.
The study was approved by the Audit, Assurance and Effectiveness Department of the University Hospitals Plymouth NHS Trust and performed with Good Ethical Standards. Reference Number: CA_2018-19-184. This department has an ethics committee for the approval of studies on humans.
Informed consent was obtained from all participants. The references should not be more than 10 years old.
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