Department of Gynecology and Obstetrics, Division of Gynecology, Perineology Unit, University Hospitals of Geneva, University of Geneva, Switzerland.
BMC Womens Health. 2009 Sep 25;9:28. doi: 10.1186/1472-6874-9-28.
The transobturator tape procedure (TOT) is an effective surgical treatment of female stress urinary incontinence. However data concerning safety are rare, follow-up is often less than two years, and complications are probably underreported. The aim of this study was to describe early and late complications associated with TOT procedures and identify risk factors for erosions.
It was a 27 months follow-up of a cohort of 233 women who underwent TOT with three different types of slings (Aris, Obtape, TVT-O). Follow-up information was available for 225 (96.6%) women.
There were few per operative complications. Forty-eight women (21.3%) reported late complications including de novo or worsening of preexisting urgencies (10.2%), perineal pain (2.2%), de novo dyspareunia (9%), and vaginal erosion (7.6%). The risk of erosion significantly differed between the three types of slings and was 4%, 17% and 0% for Aris, Obtape and TVT-O respectively (P = 0.001). The overall proportion of women satisfied by the procedure was 72.1%. The percentage of women satisfied was significantly lower in women who experienced erosion (29.4%) compared to women who did not (78.4%) (RR 0.14, 95% CI 0.05-0.38, P < 0.001).
Late post operative complications are relatively frequent after TOT and can impair patient's satisfaction. Women should be informed of these potential complications preoperatively and require careful follow-up after the procedure. Choice of the safest sling material is crucial as it is a risk factor for erosion.
经闭孔吊带术（TOT）是治疗女性压力性尿失禁的有效手术方法。然而，关于安全性的数据很少，随访时间通常不到两年，而且并发症可能报告不足。本研究旨在描述 TOT 术后早期和晚期并发症，并确定发生吊带侵蚀的危险因素。
这是对 233 名女性进行 TOT 手术的队列进行的 27 个月随访，使用三种不同类型的吊带（Aris、Obtape、TVT-O）。有 225 名（96.6%）女性的随访信息可用。
术中并发症很少。48 名女性（21.3%）报告了晚期并发症，包括新发或原有急迫性尿失禁加重（10.2%）、会阴疼痛（2.2%）、新发性交困难（9%）和阴道侵蚀（7.6%）。三种吊带类型之间的侵蚀风险明显不同，Aris、Obtape 和 TVT-O 的发生率分别为 4%、17%和 0%（P=0.001）。对手术满意的女性总体比例为 72.1%。经历侵蚀的女性（29.4%）对手术的满意度明显低于未经历侵蚀的女性（78.4%）（RR 0.14，95%CI 0.05-0.38，P<0.001）。
TOT 术后晚期术后并发症相对常见，可能会影响患者的满意度。女性在术前应被告知这些潜在的并发症，并在术后需要进行仔细的随访。选择最安全的吊带材料至关重要，因为它是发生侵蚀的危险因素。
