Retrospective study on the management and follow-up of 18 patients with a mid-urethral sling penetrating the urethra or bladder - 01/09/18
, Adélaide Jarniat b, Florian Bardet c, Lise Bergogne a, Emmanuel Delorme dBienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
| pages | 9 |
| Iconographies | 4 |
| Vidéos | 0 |
| Autres | 0 |
Abstract |
Introduction |
The mid-urethral sling (MUS) procedure is the gold-standard for the surgical treatment of stress urinary incontinence (SUI). Urethro-vesical sling exposure is one of the most serious complications of this procedure. We describe the treatment and follow-up of 18 patients with bladder or urethral sling exposure.
Patients and methods |
This single-center, retrospective study assessed the diagnosis and management of MUS penetrating the lower urinary tract in 18 women. The lesions included were classed as 4B, T3-4, S3 according to the international classification of complications related to the insertion of prostheses. Diagnosis was confirmed by flexible urethro-cystoscopy. The patients were treated surgically. In all cases, the aim was to remove all synthetic materials eroding the bladder or urethra. The patients were reassessed 6 weeks after the procedure, and functional urologic sequelae were treated. Urologic symptoms were evaluated using the USP questionnaire and urologic comfort was assessed using the Contilife questionnaire.
Results |
Seven MUSs were retro-pubic and 11 were trans-obturators. The material was 11 polypropylene macroporous monofilament, four polypropylene silicone coated and three non-available. There were six cases of urethral sling exposure, nine cases of bladder sling exposure, and three cases of urethral and bladder sling exposure, including five complicated cases of lithiasis and one urethra-vaginal fistula. Thirteen patients underwent one surgical procedure, four underwent two, and one underwent five procedures. Seven patients received a Martius flap. Three surgical approaches were necessary: (i) vaginal approach; (ii) urologic (urethral and suprapubic) cystoscopy approach; and (iii) laparoscopy approach. Median follow-up time was 34.5 months. At the end of follow-up, 17/18 patients had no sling exposure from the MUS, and 12/13 patients were considered comfortable from a functional urologic viewpoint.
Conclusion |
Our study showed that surgery could treat urethro-vesical sling exposure. Three surgical approaches may be necessary. Controlled cystoscopy is vital to confirm healing due to the recurrences of sling exposure in our study.
Le texte complet de cet article est disponible en PDF.Keywords : Bladder/urethra sling exposure, Mid-urethral sling, Retro-pubic sling, Retrospective series, Stress urinary incontinence
Plan
Vol 47 - N° 7
P. 289-297 - septembre 2018 Retour au numéro
Article précédent
- Feelings and expectations in endometriosis: Analysis of open comments from a cohort of endometriosis patients
- Pauline Chauvet, Candy Guiguet-Auclair, Aurélie Comptour, Amélie Denouël, Laurent Gerbaud, Michel Canis, Nicolas Bourdel
- Management of pregnancy based on healthcare consumption of women who delivered in France in 2015: Contribution of the national health data system (SNDS)
- Clara Piffaretti, Vincent Looten, Sylvie Rey, Jeanne Fresson, Anne Fagot-Campagna, Philippe Tuppin
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’achat d’article à l’unité est indisponible à l’heure actuelle.
Déjà abonné à cette revue ?