Managing Complications after Midurethral Sling for Stress Urinary Incontinence

Abstract

Since Ulmsten and Petros's original description of the tension-free vaginal tape (TVT) procedure in 1995, the midurethral sling (MUS) has become first-line therapy for correction of female stress urinary incontinence (SUI). Cure rates are high for TVT and the recent tension-free trans-obturator tape (TOT) procedures, and the incidence of side effects is low. In the past few years although several studies have dealt with the incidence and prevalence of MUS-related complications, their surgical management remains an open issue. This paper presents the rationale for surgical management of MUS-linked complications, updates progress in new strategies, and tracks translation of recommendations on vaginal and urethral erosion, postoperative voiding difficulties, and de novo urgency into clinical practice.