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Mini-slings can cause complications

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Abstract

Introduction and hypothesis

Single-incision mini-slings (SIMS) have been advocated to avoid the complications of transobturator and retropubic midurethral slings. We present a series of SIMS complications and their outcome after vaginal removal at a tertiary care center.

Methods

Following Institutional Review Board approval, a prospective database of consecutive women who underwent SIMS removal for complications and had a minimum follow-up of 6 months was reviewed. Patient-reported outcomes were assessed by main symptom category. In addition, an ideal outcome or cure was defined as continent, pain-free, sexually active if active preoperatively, and not requiring additional medical or surgical therapy.

Results

Of 23 women, 17 met inclusion criteria. Presenting symptoms were varied but dominated by incontinence (14), pelvic pain (11), dyspareunia (10), and obstructive urinary symptoms/urinary retention (5), with 76 % presenting with more than one complaint. Type of SIMS included MiniArc™ (11), Solyx™ (4), and TVT-Secur™ (2). At a mean follow-up of 17 ± 9 (range 7–44) months after SIMS removal, six (35 %) women were cured of their presenting complaint. Among the 11 women with pelvic pain, 6 had resolution of pain, 2 improvement, and 3 persistent pain. Six of seven women who were sexually active beforehand resumed sexual activity. Dyspareunia persisted in three women. Of 14 with incontinence, 8 had cure or improvement, and obstructive symptoms resolved in 4 of 5.

Conclusions

This series outlines several complications with SIMS, similar to what has been reported with other suburethral synthetic tapes. Therefore, caution is required and patient counseling is important.

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Abbreviations

SIMS:

Single-incision mini-slings

MUS:

Midurethral sling

TVT:

Tension-free vaginal tape

TOT:

Transobturator tape

UDI-6:

Urogenital Distress Inventory Short Form

VCUG:

Voiding cystourethrogram

SUI:

Stress urinary incontinence

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Authors and Affiliations

  1. Department of Urology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9110, USA

    Burhan Coskun, Rebecca S. Lavelle, Feras Alhalabi, Gary E. Lemack & Philippe E. Zimmern

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  1. Burhan Coskun
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  2. Rebecca S. Lavelle
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  3. Feras Alhalabi
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  4. Gary E. Lemack
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  5. Philippe E. Zimmern
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Corresponding author

Correspondence to Philippe E. Zimmern.

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Coskun, B., Lavelle, R.S., Alhalabi, F. et al. Mini-slings can cause complications. Int Urogynecol J 26, 557–562 (2015). https://doi.org/10.1007/s00192-014-2530-7

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  • DOI: https://doi.org/10.1007/s00192-014-2530-7

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