Sling distress: a subanalysis of the IVS tapes from the SUSPEND trial

Balakrishnan, Siva, Lim, Yik Nyok, Barry, Chris, Corstiaans, Audrey, Kannan, Kurinji, and Rane, Ajay (2007) Sling distress: a subanalysis of the IVS tapes from the SUSPEND trial. Australian and New Zealand Journal of Obstetrics and Gynaecology, 47 (6). pp. 496-498.

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Aim: To study the incidence of erosions and tape infections following the use of intravaginal slingplasty (IVS) treatment for stress urinary incontinence after the SUSPEND trial period of 30 months. This subanalysis was carried out because of concerns regarding high percentage of delayed sling erosions and infections during follow up of the patients who participated in the trial.

Materials and methods: The subanalysis patient group consisted of all IVS patients drawn from the SUSPEND randomised control trial that compared the safety and efficacy of three types of suburethral slings, TVT, SPARC and IVS, for the treatment of urodynamic stress incontinence.

Results: A total of 62 patients were reviewed during this study conducted from April 2002 to May 2003. Continence was achieved in 88% the patients. A total of eight (13%) sling erosions were found requiring sling removal. Forty-eight (77.4%) patients were followed up at 12 months with one case of erosion (1.7%). Twenty-nine (46.8%) of the 62 patients were followed up between 12 and 34 months, and seven cases of sling erosions were diagnosed. One patient had purulent suprapubic sinus, five patients had foul-smelling discharge, and one had recurrent urinary tract infection associated with pain and discharge. After the slings were removed the patients had no further symptoms. However, three of them had recurrent stress urinary incontinence.

Discussion/conclusion: The delayed presentation of the sling erosion from this subanalysis is a concern, and pelvic reconstructive surgeons using IVS need to be aware of the delayed presentations we found in our cohort of patients.

Item ID: 2261
Item Type: Article (Research - C1)
ISSN: 1479-828X
Keywords: intravaginal slingplasty; sling erosion; suspend trial; mesh erosion; stress urinary incontinence
Date Deposited: 29 May 2009 05:36
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1114 Paediatrics and Reproductive Medicine > 111402 Obstetrics and Gynaecology @ 80%
11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110312 Nephrology and Urology @ 20%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920119 Urogenital System and Disorders @ 75%
92 HEALTH > 9202 Health and Support Services > 920204 Evaluation of Health Outcomes @ 25%
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