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Management of the complications of the synthetic slings

Deval, Brunoa; Haab, Françoisb

Current Opinion in Urology:
doi: 10.1097/01.mou.0000232043.95427.d6
Female urology
Abstract

Purpose of review: The aim of this article is to review the last year's literature on the management of vaginal erosion and obturator abscess with suburethral tapes in the treatment of female urinary incontinence.

Recent findings: During the past decade suburethral tapes have been approved in Europe for minimally invasive treatment of stress urinary incontinence. Consensus is, however, lacking regarding the material best suited for this surgery. Although the success rates with synthetic materials have been, in general, good, the risk of vaginal extrusion and urethral erosion is considerably greater, ranging from 0.2 to 22%. We report diagnosis and management of complications occurring after this procedure. The presenting symptoms, physical findings, diagnostic procedures, surgical treatments, and outcomes are analyzed. Pain, vaginal discharge, bleeding, recurrent urinary tract infections, and/or persistent stress urinary incontinence are suspected symptoms of vaginal erosion. All vaginal erosions are usually detected by physical examination; in cases of suspected pelvic abscess, magnetic resonance imaging is performed. Total tape removal is recommended in the majority of cases; however, patients have recurrence of incontinence.

Summary: Urogenital tract erosion and pelvic abscess are significant complications of suburethral tape; immediate symptom relief is expected after removal of the eroded sling.

Author Information

aDepartment of Gynecology and Pelvic Reconstructive Surgery, Maternité Régionale Universitaire de Nancy, Nancy 54,045, France

bDepartment of Urology, Tenon Hospital, Paris VII University France

Correspondence to Dr Bruno Deval MD, Maternité Nancy, 10 rue du Docteur Heydenreish, 54000 Nancy, France Tel: +33 3 83 34 44 44; e-mail: b.deval@maternite.chu-nancy.fr

© 2006 Lippincott Williams & Wilkins, Inc.