Stanford Edward J, Paraiso Marie Fidela R
Center for Advanced Pelvic Surgery, Centralia, Illinois 62801, USA.
J Minim Invasive Gynecol. 2008 Mar-Apr;15(2):132-45. doi: 10.1016/j.jmig.2007.11.004. Epub 2008 Jan 31.
The study objective was to review the existing literature regarding complications of anti-incontinence sling procedures. PubMed listings using keywords related to slings and associated complications with no date or language restrictions through May 2007 and the Manufacturer and User Facility Device Experience Database were searched for specific device- and procedure-related complications. Where no information was available, published abstracts were cited. Published reports of complications for all types of anti-incontinence sling procedures are analyzed and reported. Sling-related complications are multiple but can be summarized from studies on 13737 cumulative patients as involving: voiding dysfunction (8 studies, 881 patients, 16.3% average overall incidence [OI]); detrusor overactivity (20 studies, 1950 patients, 15.4% OI); urinary retention (14 studies, 943 patients, 14.2% OI); erosion/extrusion (19 studies, 2197 patients, 6.03% OI); impact on quality of life-dyspareunia (2 studies, 175 patients, 4.3% OI); infections-most often urinary tract infections but severe infections such as abscess are reported (19 studies, 1487 patients, 5.5% OI); hematoma-most often pelvic or vaginal (4 studies, 3691 patients, 2% OI); pain (6 studies, 597 patients, 7.3% OI); abdominal and pelvic organ injury-bladder, urethra, vagina, and intestines (10 studies, 1816 patients, 3.3% OI); systemic complications-deep vein thrombosis, sepsis (case reports); and death (case reports). Cure rates for all slings are as follows: subjective (16 studies, 1541 patients, 95% OI, range 63%-99%), objective (15 studies, 1203 patients, 82% OI, range 51%-97%), and failure (8 studies, 599 patients, 11.5% OI, range 4%-37%). It is likely that sling-related complications are under-reported in the published medical literature and in the Manufacturer and User Facility Device Experience Database. This review reports on the incidence of known complications for all types of slings. Some complications are common to all sling techniques; however, with development of minimally invasive slings, device-related complications are reported and compared.
本研究的目的是回顾关于抗尿失禁吊带手术并发症的现有文献。通过检索截至2007年5月不受日期或语言限制的、使用与吊带及相关并发症相关关键词的PubMed列表以及制造商和用户设施设备经验数据库，查找特定的与设备和手术相关的并发症。在没有可用信息的情况下，引用已发表的摘要。对所有类型抗尿失禁吊带手术的并发症发表报告进行分析并报告。与吊带相关的并发症多种多样，但可根据对13737例累积患者的研究总结为：排尿功能障碍（8项研究，881例患者，总体平均发生率[OI]为16.3%）；逼尿肌过度活动（20项研究，1950例患者，OI为15.4%）；尿潴留（14项研究，943例患者，OI为14.2%）；侵蚀/挤出（19项研究，2197例患者，OI为6.03%）；对生活质量的影响——性交困难（2项研究，175例患者，OI为4.3%）；感染——最常见的是尿路感染，但也有严重感染如脓肿的报告（19项研究，1487例患者，OI为5.5%）；血肿——最常见于盆腔或阴道（4项研究，3691例患者，OI为2%）；疼痛（6项研究，597例患者，OI为7.3%）；腹部和盆腔器官损伤——膀胱、尿道、阴道和肠道（10项研究，1816例患者，OI为3.3%）；全身并发症——深静脉血栓形成、败血症（病例报告）；以及死亡（病例报告）。所有吊带的治愈率如下：主观治愈率（16项研究，1541例患者，OI为95%，范围为63%-99%），客观治愈率（15项研究，1203例患者，OI为82%，范围为51%-97%），失败率（8项研究，599例患者，OI为11.5%，范围为4%-37%）。在已发表的医学文献以及制造商和用户设施设备经验数据库中，与吊带相关的并发症可能报告不足。本综述报告了所有类型吊带已知并发症的发生率。一些并发症是所有吊带技术共有的；然而，随着微创吊带的发展，报告并比较了与设备相关的并发症。
