Palthe, S. (2015) Postoperatieve complicaties van mid-urethrale tapes bij stressincontinentie, de behandeling van deze complicaties en de impact van de complicaties op het leven van de patiënt. thesis, Medicine.
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Abstract
Introduction Stress urinary incontinence is defined as involuntary loss of urine coincident with increased intra-abdominal pressure. Stress incontinence has a high incidence in women. One of the treatment options is a mid-urethral tape (a retropubic tape or transobturator tape). Complications which can occur after placement of the mid-urethral tape are erosion of the tape into the bladder or urethra, exposure of the tape in the vagina, persistent pain, dyspareunia, obstruction or urge incontinence. Treatment options for the complications are medication, tape release and excision of the tape. In this study we will describe the complications that can occur after placement of a mid-urethral tape. We will also describe how the complications have been treated and what the impact of the complications is on the lives of the patients. Methods Women, above the age of 18 years old, with a complication after a mid-urethral tape procedure who have been treated in the UMCG between 2010 and 2014 for their complication are included. In the control group women, also above the age of 18 years old, without a complication after a mid-urethral tape procedure are included. Data were collected through searching the patient files and sending out questionnaires. Results Complications that were reported in our study were persistent pain (46,2%), obstruction (33,3%), tape exposure (23,2%), erosion of the tape in the bladder or urethra (both 18,0%), urge incontinence (18,0%) and dyspareunia (15,4%). Treatment options were observation, pelvic floor muscle training, medication, injection with local anesthesia, tape release or excision of the tape. Patiënts with a complication after a mid-urethral tape had a significantly lower quality of life compared to patients without a complication. After treatment there was no significant difference between both groups. Compared to patients without a complication patients with a complication had significantly more persistent pain and dyspareunia after treatment of the complication. Discussion Complications after mid-urethral tapes are serious postoperative complications. Qualities of this study are different measurements in time and the fact that we compare two groups; patients with and patients without a complication. Limitations are the retrospective study design as well as not using standardized treatments to treat the complications. Conclusion Complications that can occur after placement of the mid-urethral tape are persistent pain, obstruction, tape exposure, erosion of the tape into the bladder or urethra, urge incontinence and dyspareunia. Patients who have been treated for their complication have significantly more persistent pain and dyspareunia compared to patients without a complication. So management of persistent pain and dyspareunia seems insufficient and these two complications will require optimization of treatment in the future. Due to the significant impact of the complications on the quality of life of the patient some reticence is important in indicating surgical intervention as treatment for stress incontinence.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Messelink, drs. E.J. uroloog and Universitair Medisch Centrum Groningen and Afdeling Urologie |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:52 |
| Last Modified: | 25 Jun 2020 10:52 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1288 |
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