Journal
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
Volume 193, Issue 1, Pages 45-52Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.ajog.2004.11.004
Keywords
stress urinary incontinence; incontinence surgery; tension-free vaginal tape; complication; learning curve
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Objective: The intra- and postoperative anatomic complications, frequency, and influence of risk factors of the tension-free vaginal tape are described. Study design: This was a prospective cohort study of 809 patients. Results: The total intraoperative complication rate was 6.2%. Previous prolapse surgery was a risk factor for complications (odds ratio, 2.86; 95% CI, 1.15-7.11). We found more intraoperative complications in patients with general anesthesia than with local analgesia with sedation (odds ratio, 4.14; .95% CI, 2.01-8.53). In teaching hospitals the postoperative complication frequency was higher than in non-teaching hospitals (odds ratio, 0.55; 95% CL 0.35-0.85). The learning curve is short, and more postoperative complications were found in the second 10 patients who underwent operation by I surgeon (odds ratio, 1.94; 95% Cl, 1.14- 3.29). Spinal analgesia gives fewer postoperative complications than local analgesia with sedation (odds ratio, 0.35; 95% CI, 0.13- 0.92). Conclusion: Tension-free vaginal tape is a relative safe procedure; concomitant pelvic surgery can be performed safely. Several risk factors for complications were identified: menopausal state, previous prolapse surgery, mode of anesthesia, teaching hospital, and the second ten procedures of each surgeon. (c) 2005 Elsevier Inc. All rights reserved.
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