Are complications of stress urinary incontinence surgery procedures associated with the position of the sling?

作者：Kociszewski Jacek; Fabian George; Grothey Susanne; Kuszka Andrzej; Zwierzchowska Aneta; Majkusiak Wojciech; Barcz Ewa^*

来源：International Journal of Urology, 2017, 24(2): 144-149.

DOI：10.1111/iju.13262

• overactive bladder
• postoperative complications
• stress urinary incontinence
• suburethral slings
• ultrasound imaging

Objectives: To evaluate whether the sling position is associated with particular types of complications in patients undergoing suburethral sling placement for stress urinary incontinence.
Methods: Data from 100 women diagnosed at the Evangelical Hospital Hagen-Haspe with complications after suburethral sling insertion were analyzed. All patients underwent pelvic floor ultrasound to assess: urethral length, sling location in relation to the urethral length (%) and the sling distance to the longitudinal smooth muscle complex of the urethra (the sling-longitudinal smooth muscle distance).
Results: The shortest median sling-longitudinal smooth muscle distance was observed in patients with recurrent urinary tract infections, urinary retention and overactive bladder: 0.9, 1.1 and 1.75 mm, respectively (P < 0.05). In women with persistent stress urinary incontinence and sling erosion, the sling-longitudinal smooth muscle distance was 3.6 and 4.6 mm, respectively (P < 0.05). Persistent stress urinary incontinence was connected with the position of the sling in relation to the bladder neck -in these patients, the sling was closer to the bladder neck.
Conclusions: Sling location plays a pivotal role in the occurrence of certain complications. The sling position in the proximal part of the urethra or between the middle and proximal urethra appears to be connected with a high rate of unsuccessful stress urinary incontinence treatment. A sling-longitudinal smooth muscle distance below 2 mm is often connected with sling complications, such as overactive bladder, urinary retention and recurrent urinary tract infections.

• 出版日期2017-2