Urinary tract erosions after synthetic pubovaginal slings: diagnosis and management strategy.

Published

Journal Article

OBJECTIVES: To review our experience with the diagnosis and management of genitourinary tract erosions after pubovaginal sling placement. METHODS: Clinic and operative records from the urology and gynecology services at two university hospitals were reviewed, and 14 patients were identified who underwent surgical treatment for a urogenital tract erosion after pubovaginal sling placement. The presenting symptoms, physical findings, diagnostic procedures, surgical treatments, and outcomes were reviewed. RESULTS: Six vaginal erosions, six urethral and vaginal erosions, and two bladder erosions occurred. All were associated with synthetic sling or suture materials. Common symptoms included vaginal and urethral pain, irritative voiding symptoms, vaginal discharge and/or bleeding, and recurrent urinary tract infections. All vaginal and urethral erosions were detected by physical examination and cystoscopy. Symptoms resolved after removal of the eroded sling component. Of the 12 patients with vaginal or urethral erosions, 7 developed recurrent postoperative stress incontinence. CONCLUSIONS: Persistent painful or irritative symptoms after pubovaginal sling placement may be due to urogenital tract erosion, especially if synthetic materials were used. Appropriate evaluation and treatment will result in dramatic symptomatic improvement, although recurrent stress incontinence may occur.

Full Text

Duke Authors

Cited Authors

  • Clemens, JQ; DeLancey, JO; Faerber, GJ; Westney, OL; Mcguire, EJ

Published Date

  • October 1, 2000

Published In

Volume / Issue

  • 56 / 4

Start / End Page

  • 589 - 594

PubMed ID

  • 11018611

Pubmed Central ID

  • 11018611

Electronic International Standard Serial Number (EISSN)

  • 1527-9995

Language

  • eng

Conference Location

  • United States