El-Hefnawy Ahmed S, Wadie Bassem S
Urogynecology and Voiding Dysfunction Section, Urology Department, Urology and Nephrology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Curr Urol. 2021 Jun;15(2):101-105. doi: 10.1097/CU9.0000000000000018. Epub 2021 May 20.
To construct a modified model for reporting and grading of postoperative complications after the mid-urethral sling (MUS) procedure based on the Clavien-Dindo classification. In addition, complications of three different types of MUS were compared.
A PubMed search for postoperative complication after MUS was carried out for the period between January 1990 and July 2018. Reported complications were stratified in a plate form designed in accordance with grades of the Clavien-Dindo classification. Then, the proposed model was applied on reported complications in 160 females who underwent three different procedures of MUS (transvaginal tape [TVT], transobturator tape [TOT], and autologous fascial sling) with a minimum follow-up of 24 months.
The mean ± SD age at time of surgery was 46 ± 7 years. TVT was carried out in 75 (47%) patients, TOT in 40 (25%), and fascial sling in 45 (28%). The total number of complications was 62 in 43 (26.8%) patients. The vast majority of complications were Grade I and Grade II 19 (12%) and 21 (13%) out of 160 patients, respectively. Transient postoperative voiding difficulty (Grade II) and de novo urgency (Grade II) were the most prevalent complications in the fascial sling method (15.4% for each), whereas transient thigh pain (Grade II) was the most frequently reported complication after TOT (10%). Life-threatening vascular injury (Grade IV-a) was a serious complication in TVT cases.
Postoperative complications of the MUS could be graded according to Clavien's classification. The vast majority of complications were Graded I or II. TVT can cause serious life-threatening complications.
基于Clavien-Dindo分类法构建改良模型，用于报告和分级经尿道中段吊带术（MUS）术后并发症。此外，比较三种不同类型MUS的并发症。
在PubMed上检索1990年1月至2018年7月期间MUS术后并发症的相关文献。将报告的并发症按照根据Clavien-Dindo分类法的等级分层于一个表格形式中。然后，将该模型应用于160例接受三种不同MUS手术（经阴道无张力尿道中段吊带术[TVT]、经闭孔无张力尿道中段吊带术[TOT]和自体筋膜吊带术）且至少随访24个月的女性患者所报告的并发症。
手术时的平均年龄±标准差为46±7岁。75例（47%）患者接受TVT手术，40例（25%）接受TOT手术，45例（28%）接受筋膜吊带术。43例（26.8%）患者共发生62例并发症。绝大多数并发症为Ⅰ级和Ⅱ级，分别占160例患者中的19例（12%）和21例（13%）。术后短暂性排尿困难（Ⅱ级）和新发尿急（Ⅱ级）是筋膜吊带术最常见的并发症（各占15.4%），而短暂性大腿疼痛（Ⅱ级）是TOT术后最常报告的并发症（10%）。危及生命的血管损伤（Ⅳ - a级）是TVT病例中的严重并发症。
MUS术后并发症可根据Clavien分类法分级。绝大多数并发症为Ⅰ级或Ⅱ级。TVT可导致严重的危及生命的并发症。
