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Management of mid-urethral tape complications: a retrospective study

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The Journal of Obstetrics and Gynecology of India Aims and scope Submit manuscript

Abstract

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.

Methods

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.

Results

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.

Conclusions

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.

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Acknowledgement

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.

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Authors and Affiliations

  1. Department of Urogynaecology, University Hospitals Plymouth NHS Trust, Derriford Road, Plymouth, Devon, PL6 8DH, England, UK

    Ifeoma Offiah, Suneetha Rachaneni & Anupreet Dua

  2. Shrewsbury and Telford Hospital NHS Trust, Mytton Oak Rd, Shrewsbury, SY3 8XQ, England, UK

    Suneetha Rachaneni

Authors
  1. Ifeoma Offiah
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  2. Suneetha Rachaneni
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  3. Anupreet Dua
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Corresponding author

Correspondence to Ifeoma Offiah.

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Conflict of interest

Ifeoma Offiah, Suneetha Rachaneni and Anupreet Dua declare that they have no conflict of interest.

Ethical standard

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

Informed consent was obtained from all participants. The references should not be more than 10 years old.

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Dr. Ifeoma Offiah is a National Institute of Health Research (NIHR) Clinical Lecturer appointed by the University of Plymouth. Dr. Suneetha Rachaneni is a Consultant and Subspecialist Urogynaecologist. Dr. Anupreet Dua is a Consultant and Subspecialist Urogynaecologist, College Tutor and SST Program Director.

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Offiah, I., Rachaneni, S. & Dua, A. Management of mid-urethral tape complications: a retrospective study. J Obstet Gynecol India 70, 152–157 (2020). https://doi.org/10.1007/s13224-019-01269-5

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  • DOI: https://doi.org/10.1007/s13224-019-01269-5

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