Short term complications of the tension free vaginal tape operation for stress urinary incontinence in women.

Objective: To assess the prevalence of intra- and post-operative complications with the tension free vaginal tape operation for female urinary incontinence.

Design: Non-control case series.

Setting: University Hospital.

Population: One hundred and seventy-seven operations on women who were diagnosed urodynamically to have genuine stress incontinence. In 26 cases (15%) there was symptomatic urge incontinence.

Main Outcome Measures: Intra- and post-operative complications in relation to individual surgeons and mode of anaesthesia (local or spinal), and continence at short term follow up.

Results: Bladder or urethral perforation occurred in 26 cases (15%) and three operations were abandoned for these reasons. A failure to void after the first 24 hours was registered in 35 (20%); 21 (12%) had to undergo urethral dilatation while five patients (2.8%) had persistent urinary retention which required excision of the sling. These problems were significantly associated to the experience of surgeon. In seven cases (4%) haemorrhage required intravaginal tamponade. In three (1.7%) sling rejection occurred post-operatively. When followed up six to eight weeks post-operatively, 154 patients (88%) reported subjective cure, 21 (11%) significant improvement and two (1%) no improvement. The use of spinal anaesthesia increased the frequency of peroperative bladder perforation but affected neither the incidence of post-operative bladder obstruction nor the outcome at follow up.

Conclusions: This study identifies short term complications which relate partly to the experience of the individual surgeon. Nevertheless the 88% subjective cure rate was independent of these factors.