[Complications of TVT]

Area of Science:

• Urology
• Gynecology
• Surgical Innovation

Context:

• The introduction of transvaginal tape (TVT) for stress urinary incontinence in 1998 lacked comprehensive pre-market morbidity evaluation.
• The Necker 2002 report initiated a literature review and multicenter study to assess TVT-related morbidity.
• Early adoption of TVT procedures highlighted learning curve challenges and potential complications.

Purpose:

• To evaluate the morbidity associated with transvaginal tape (TVT) procedures for stress urinary incontinence.
• To clarify the risks and complications following TVT surgery based on literature review and multicenter data.
• To provide evidence-based insights into the safety profile of TVT for stress urinary incontinence treatment.

Summary:

• Bladder perforation, common during the initial learning curve, necessitates repositioning and catheterization but does not increase postoperative morbidity.
• Urethral perforation is a rare complication and a contraindication for TVT placement.
• Postoperative obstruction (5-12%) requires self-catheterization to avoid early TVT section; de novo instability (6-12%) is linked to incomplete obstruction or a gaping bladder neck.
• Vaginal erosions are uncommon complications associated with TVT.

Impact:

• This study provides crucial data on the safety and potential complications of TVT surgery, informing clinical practice.
• Understanding these morbidities allows for better patient selection, surgical technique refinement, and improved postoperative management.
• The findings contribute to the ongoing assessment of TVT as a standard surgical treatment for stress urinary incontinence.