Management of sling surgery complications

Abstract

The management of urodynamically proven stress urinary incontinence underwent a paradigm shift with the focus changing from bladder neck suspension to support of the mid-urethra in the last two decades. This has resulted in the replacement of Burch colposuspension and pubovaginal slings to synthetic mid-urethral slings as the primary surgical option in women with stress urinary incontinence (SUI). The introduction of synthetic mid-urethral slings has resulted in good objective and subjective cure rates but can be associated with complications that pose a challenge to the treating surgeon. Surgical treatment for SUI has rapidly evolved and the initially introduced mid-urethral sling, retropubic tension-free vaginal tape (TVT), is accepted worldwide as a standard treatment for women suffering from SUI. However, slings have been associated with a few early and delayed complications which may result in varying degrees of morbidity. Serious complications such as bowel injury, major vascular injury, and even death have been reported with mid-urethral sling procedures.