Division of Urogynecology, Department of Obstetrics and Gynecology, University of Greifswald, Greifswald, Germany.
Eur J Obstet Gynecol Reprod Biol. 2012 Dec;165(2):347-51. doi: 10.1016/j.ejogrb.2012.08.011. Epub 2012 Sep 1.
To analyze different complications of synthetic suburethral slings, and to apply the new "IUGA-ICS classification of complications directly related to the insertion of prosthesis (meshes, implants, tapes) and grafts in female pelvic floor surgery" to the list of complications, check its applicability, and give suggestions regarding possible improvements.
This study is an analysis of complications of synthetic suburethral slings. Data on type of complication, time interval between the insertion of the prosthesis and the onset of symptoms of complication, type and nature of prosthesis, and management process were documented. Additional descriptions of the sling position in relation to lower urinary tract, shrinkage or prominence of the prosthesis, and intra-operative nature of the prosthetic material were collected for analysis.
From the year 2003 to 2010, 376 women with complications of synthetic suburethral slings were managed surgically and the data were analyzed. Overactive bladder (OAB) at 54%, lower urinary tract obstruction (48%), vaginal exposure (19%), and pain (14%) were the most frequent complications. Infection, fistulae, urinary tract penetration, and groin/thigh pain were other complications. The new IUGA-ICS classification could be applied to most of the types of complications, a notable exception being de novo development of overactive bladder. Also category 4B of IUGA-ICS classifications encompasses a wide clinical variety of complications and may need reconsideration.
De novo OAB seems to be the commonest complication of synthetic suburethral slings, followed by obstruction, vaginal exposure, and long term pain. The new IUGA-ICS classification on complications has good general applicability; some minor changes may be useful in the future.
分析合成尿道下吊带的不同并发症，并将新的“女性盆底外科中与假体（网片、植入物、吊带）和移植物插入直接相关的并发症的 IUGA-ICS 分类”应用于并发症列表，检查其适用性，并就可能的改进提出建议。
本研究是对合成尿道下吊带并发症的分析。记录了并发症的类型、假体插入与并发症症状出现之间的时间间隔、假体的类型和性质以及处理过程的数据。还收集了吊带在与下尿路的关系、假体的收缩或突出以及假体材料的术中性质等方面的附加描述，以进行分析。
2003 年至 2010 年，376 名患有合成尿道下吊带并发症的女性接受了手术治疗，并对其数据进行了分析。最常见的并发症是膀胱过度活动症（OAB）占 54%、下尿路梗阻（48%）、阴道暴露（19%）和疼痛（14%）。感染、瘘管、泌尿道穿透和腹股沟/大腿疼痛是其他并发症。新的 IUGA-ICS 分类可应用于大多数类型的并发症，但有一个明显的例外，即新发性膀胱过度活动症。此外，IUGA-ICS 分类的 4B 类还包含了广泛的临床并发症种类，可能需要重新考虑。
合成尿道下吊带的最常见并发症似乎是新发性 OAB，其次是梗阻、阴道暴露和长期疼痛。新的 IUGA-ICS 并发症分类具有良好的通用性；未来可能需要进行一些小的更改。
