Fræðigrein

Læknablaðið 2005; 91: 237-41

Objective: The usage of non-absorbable synthetic materials in female incontinence surgery could give rise to serious complications. The aim of this study was to describe results of reoperations due to foreign body near or within lower urinary tract in female patients previously undergoing stress incontinence surgery.

Material and methods: This was a retrospective study of patients referred to the author with miscellaneous symptoms after stress incontinence surgery. The reoperations were performed in the period March 1996 to May 2004. All patients were followed after reoperation. Results are given as median, minimum and maximum value.

Results: Ten patients with median age 59,5 (28-82) years were reoperated between half and 56 months from the primary operation. Urinary infection, pain, incontinence and various lower urinary tract symptoms were the most common symptoms. Nine patients were diagnosed by cystoscopy. Four had previously undergone tension-free vaginal tape surgery (TVT), four needle suspension surgery and two retropubic colposuspension. Seven were reoperated with open retropubic surgery, in two cases TVT was removed below urethra and non-absorbable suture was removed transvaginally in one patient. Foreign body was within the lower urinary tract in seven cases. In three cases, transurethral endoscopic removal of foreign body was performed without long-term success and further surgery needed. The overall results of the reoperations was very satisfying in terms of complete removal of foreign bodies and regress of symptoms. Convalescence was uneventful and only one patient got superficial skin infection. No other complications occurred. None has needed further reoperations in the follow-up period (6-78 months).

Conclusions: Complications after usage of non-absorbable material in stress incontinence surgery could be serious and give chronic urinary symptoms. It is very important for the surgeon to be aware of this in all patients having unsuccessful recovery after incontinence surgery.