Early complications of the transobturator tape and mini sling procedure

Abstract

Objective: To compare perioperative and postoperative complications of mini sling and transobturator tape (TOT) operations in the surgical treatment of female urinary incontinence. Material and methods: After the urodynamic evaluation of the patients with stres urinary incontinence or cases with mixed urinary incontinence with significant stress factor,130 cases who underwent TOT procedure and 151 cases who underwent mini sling procedure were compared in terms of complications. The duration of follow up in the TOT group was 6-30 (mean 18) months and it was 6-21 (mean 13,5) months in the mini sling group. Results: The mean age of the mini sling and TOT group was 49 ± 10 and 50,5 ± 9,5 respectively. There was no intraoperative bladder or urethral perforation. There were no major vessel or nerve injury in both groups. In 5 (3.8%) cases of the TOT group and 6 cases (4%) of the mini sling group, intraoperative vaginal sulcus erforation developed and mucosal defects immediately sutured. Mesh extrusion was detected in 6 (4.6%) and 18 (10.9%) cases of the TOT and mini sling group, respectively. There was a statistically significant difference about mesh extrusion (p= 0.036). Ten patients (6.1%) and eight cases (6.15%) had de novo urge incontinence responsed to medical theraphy in the post-operative follow-up in the mini sling and TOT groups, respectively. Two patients (1.2%), who underwent the mini sling procedure, required sling section due to prolonged bladder outlet obstruction. Significant infection complication adherence to operation was not detected. Three and one cases complained of thigh pain in the TOT and mini sling group, respectively. Conclusion: Mini sling procedure,when compared with suburethral tape,had similar complication rates except relatively high mesh erosion rates with comparable success rates. All cases should be carefully followed for late complications.