As part of a study researchers have traced what happened to the urological tapes over a long period of time in 95,000 women who underwent surgical treatment for stress urinary incontinence.
According to a review of 2017 of the British National Health Service, namely, the Scottish Administration, complications often arise if urinary incontinence in women is treated minimally invasively by installing a loop. In addition, the report indicates a lack of observation data for a long period of time. Such data were provided only by British scientists. In this regard, within nine years, 30 women had the loop removed.
The researchers retrospectively analyzed outpatient cards of 95,057 women who, at the age of about 51, underwent sling surgery in English hospitals of the National Health Service from 2006 to 2015. The follow-up period was five years on average. Nearly two thirds of the women had a urological tape installed through the retropubic approach, the rest through the obturator foramen.
A year after the urological operation, 1.4% of all the women had their tape removed. Five and nine years later the number increased to 2.7% and, accordingly, 3.3%. At the same time, the risks were higher in the patients operated on through the retropubic approach (3.6% versus 2.7% nine years later). Elderly women removed the tape less frequently (nine years later 2.1% of those aged over 70 versus 4.4% of those aged under 39).
Repeated surgery for the treatment of urinary incontinence was performed a year later, and after five and nine years, in 1.3%, 3.5% and 4.5% of all the women. In this case, women who were operated on through the obturator foramen were at a disadvantage. Nine years later, the risk of removal was 5.3% versus 4.1% of those operated on through the retropubic approach.
If we consider both types of surgery, the frequency of removal after one, five and nine years reached 2.6%, 5.5% and 6.9%. There wasn’t any statistically significant difference between the techniques used. As with repeated operations, because of the persistent incontinence, the risk for the next intervention increases if women have already performed other minimally invasive procedures before the sling surgery, for example, had a volumerizing preparation introduced into the submucosal layer of the urethra.
The drawback of the study is that the exact reasons for the loop removal and the subsequent surgery were not known. The fact that the risk of removing the tape installed through the obturator foramen is 30% lower, according to the study authors, may simply mean that the tape in this position is more difficult to remove.