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Int Urogynecol J (2012) 23:453457 DOI 10.1007/s00192-011-1595-9
ORIGINAL ARTICLE
Suburethral sling in autoimmune patients: complications, quality of life, and success rate
Roberto Angioli & Roberto Montera & Francesco Plotti &
Corrado Terranova & Alessia Aloisi &
Marzio Angelo Zullo
Received: 23 May 2011 /Accepted: 18 October 2011 /Published online: 9 November 2011 # The International Urogynecological Association 2011
AbstractIntroduction and hypothesis Suburethral sling procedures are a mainstay for the surgical treatment of stress urinary incontinence (SUI). The interaction between the sling and the host is fundamental for the success of the procedure. Patients affected by autoimmune disease present with an overactive immune system; this should theoretically increase rejection risk.
Methods The data from 19 autoimmune patients affected by SUI were retrospectively collected. Primary outcome consisted of evaluating whether tape-related complications may occur more frequently. Secondary outcome measures were assessment of objective and subjective cure of SUI. Changes from baseline were analyzed using the Mann Whitney and Fisher tests.
Results Success rate, evaluated at 12-month follow-up, was89.5%. No tape erosion or urinary retention was observed; chronic pelvic pain and dyspareunia rates were 5.26% and15.4%, respectively. One patient developed de novo urgency.
Conclusions According to our experience, the suburethral sling is a safe procedure with low complication rates comparable to those reported in the literature.
Keywords Autoimmune diseases . Mesh rejection .
Suburethral sling . Tape-related complications . TVT-O
Introduction
Stress urinary incontinence (SUI) is a common problem in adult women, with a prevalence of 1550%. Minimally invasive suburethral sling procedures are considered the standard surgical procedure for SUI since 1995; Ulmsten and Petros [1] were primarily responsible for this major paradigm shift for the surgical treatment of women affected by SUI [2].
Despite the high success rate, about 90% and 72.2% at 1- and 5-year follow-up, respectively [36], patients can be exposed to tape-related complications such as vaginal erosion, pelvic pain, de novo urgency, and urinary retention or dyspareunia, which reduces patient satisfaction.
Interaction between the mesh and the host is fundamental for the success of the procedure. In fact, while the inflammatory phases are necessary for the desired fibrosis to occur, if inadequate, this may led to failure and, if uncontrolled, to graft rejection.
Patients affected by autoimmune disease present an overactive immune system...