Long term results after complication of "prophylactic" suburethral tape placement

Area of Science:

• Urogynecology
• Female Pelvic Medicine and Reconstructive Surgery

Background:

• Complications following prophylactic midurethral sling (MUS) placement during prolapse repair require long-term outcome assessment.
• Understanding the sequelae of "prophylactic" MUS is essential for patient counseling and surgical decision-making.

Purpose of the Study:

• To report the long-term results of complications arising after prophylactic midurethral sling (MUS) placement during prolapse repair.
• To evaluate outcomes after surgical repair of these complications.

Main Methods:

• Retrospective review of patients with MUS complications and at least 1 year follow-up post-repair.
• Data collection included patient demographics, surgical details, presenting complaints, symptom duration/severity, and post-repair outcomes.

Main Results:

• Ten patients underwent transvaginal suburethral tape excision for "prophylactic" MUS complications.
• Post-excision, 5 patients required further surgery for secondary stricture, infection, incontinence, or prolapse; 3 had persistent lower urinary tract symptoms (LUTS).
• Pain resolved in all patients who experienced it.

Conclusions:

• "Prophylactic" MUS placement is associated with significant complications necessitating removal and potentially further interventions.
• Persistent LUTS may require ongoing management, highlighting the need for careful consideration and informed patient consent.
• The risks associated with "prophylactic" MUS must be weighed against potential benefits, emphasizing shared decision-making.