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Failures and complications in pelvic floor surgery

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Abstract

Objectives

To review current literature on the failures of different surgical approaches in pelvic floor surgery, in particular the use of alloplastic materials, and to analyze complications related to them.

Methods

A Medline search was performed to retrieve English language literature (from the year 1995 to 2011) on the success rates, failures, and complications profiles of pelvic floor surgery. Search terms used are “pelvic organ prolapse,” “stress urinary incontinence,” “complications,” “vaginal mesh,” “mid-urethral slings,” and “colposuspension.” The review includes surgical techniques for the correction of pelvic organ prolapse and stress urinary incontinence. Failure rates and complications in different studies are compiled and analyzed.

Results

Use of synthetic materials in pelvic organ prolapse surgery has reduced surgical failures but it is associated with an increased risk of complications compared to traditional surgical repairs. Synthetic mid-urethral slings for stress urinary incontinence seem to have good success rates over long term, but they have unique complication profile including denovo development of overactive bladder, voiding dysfunction, sling exposures, dyspareunia, and long-term pain. However, some of these complications seem to be related to wrong surgical indications and improper surgical techniques, although some complications may be directly related to the use of synthetic material itself.

Conclusion

Use of synthetic materials in pelvic floor surgery has definitely reduced surgical failures, but at the same time, it is associated with an increased risk of complications (some of which are unique to synthetic materials) compared to traditional surgical repairs.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Consultant Gynecologist and Urogynecologist, ESIC Medical College, Rajajinagar, Bangalore, 560010, India

    Kiran Ashok

  2. Division of Urogynecology, Department of Obstetrics and Gynecology, University of Greifswald, Greifswald, Germany

    Eckhard Petri

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  1. Kiran Ashok
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  2. Eckhard Petri
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Correspondence to Kiran Ashok.

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Ashok, K., Petri, E. Failures and complications in pelvic floor surgery. World J Urol 30, 487–494 (2012). https://doi.org/10.1007/s00345-011-0808-7

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  • DOI: https://doi.org/10.1007/s00345-011-0808-7

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