Sling exposure after treatment of urinary incontinence with sub-urethral transobturator slings

ObjectiveSub-urethral slings are the “gold standard” when treating female urinary incontinence, but placing the prosthetic material has its own specific complication, exposure.Study designA retrospective study was performed on all patients who had a sub-urethral sling (TVT-O or TVT Secur) in Lille University Hospital Centre from 2006 to 2008. Follow-up was undertaken to look for re-intervention and to try to determine the risk factors.ResultsA total of 386 patients were studied with a median follow-up of 4 years. The rate of exposure was 4.32%. TVT Secur gave rise to more exposures (13.79%) than TVT-O (3.51%) (p = 0.0203). Association with Prolift for cure of prolapse significantly reduced the rate of exposure of sub-urethral slings (p = 0.0161).ConclusionsIt seems important not to use mini-slings of the TVT Secur type as they induce a higher rate of prosthetic exposure. Cure of urinary incontinence may be done with cure of prolapse at the same surgical operation without higher risk of exposure.