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Pain after suburethral sling insertion for urinary stress incontinence
Jonathan Duckett1, Andrew Baranowski
1Department of Obstetrics and Gynaecology, Medway NHS Foundation Trust, Windmill Road, Gillingham, Kent ME7 5NY, UK. jraduckett@hotmail.com
International Urogynecology Journal
|July 4, 2012
Summary
Pain after suburethral sling surgery can be a difficult complication. Treatments range from conservative management and injections to surgical removal, though removal carries risks of recurrent incontinence and further nerve damage.
Area of Science:
- Urology
- Gynecology
- Pain Management
Background:
- Pain following suburethral sling insertion is an infrequent but debilitating complication of continence surgery.
- This complication is often unrecognized and inadequately managed by healthcare professionals unfamiliar with its nuances.
Purpose of the Study:
- To review the current evidence regarding pain after suburethral sling insertion.
- To outline diagnostic and management strategies for this challenging condition.
Main Methods:
- A comprehensive literature review was conducted.
- Existing evidence on the incidence, diagnosis, and treatment of post-sling pain was systematically evaluated.
Main Results:
- The tension-free vaginal tape-obturator (TVT-O) procedure is linked to a higher rate of early groin pain, often resolving with time.
- Chronic pain management may involve local anesthetic and steroid injections, cognitive behavioral therapy, or, in refractory cases, surgical excision.
- Surgical removal of retropubic slings can be performed laparoscopically or openly, while obturator tapes may necessitate groin exploration.
Conclusions:
- Sling removal can lead to recurrent incontinence and additional tissue or nerve damage.
- Surgical intervention for pain relief is not always successful and may worsen the condition.
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