Complications of the tension-free vaginal tape procedure for stress urinary incontinence

Introduction and hypothesis The purpose of the study was to determine the intraoperative and immediate postoperative complications of tension-free vaginal tapes (TVTs) and risk factors contributing to these. Methods The study was a retrospective cohort study of 778 TVT procedures. Results The intraoperative and postoperative complications from the study are as follows: Intraoperative complications included bladder perforation (6.6%), blood loss requiring transfusion (0.6%), and laparotomy (0.1%). Postoperatively, 3.1% of patients developed UTI, while 56.0% had difficulty voiding, and 16.6% had retention. Upon discharge, 54.8% of patients voided, 34.3% self-catheterized, and 8.0% had indwelling catheters. Surgeons responsible for more than 100 TVT procedures had one third the odds of a bladder perforation. Previous incontinence or prolapse surgery were risk factors for bladder perforation. Women with voiding dysfunction preoperatively had a 1.80-fold odds of difficulty postoperatively. Conclusion Bladder perforation and postoperative retention are the most common complications of TVTs. Risk factors for perforation include less frequent TVT performance and previous prolapse, or incontinence surgery. Preexisting voiding dysfunction leads to postoperative retention.