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      Outcome of tension-free vaginal tape procedure when complicated by intraoperative cystotomy.

      American Journal of Obstetrics and Gynecology
      Academic Medical Centers, statistics & numerical data, Aged, Body Mass Index, Connecticut, epidemiology, Cystoscopy, Equipment Design, Female, Humans, Incidence, Middle Aged, Surgical Tape, Treatment Outcome, Urinary Bladder, injuries, Urinary Incontinence, Stress, pathology, surgery, Urologic Surgical Procedures, adverse effects, Vagina, Wounds, Penetrating, etiology

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          Abstract

          The objective of this study was to determine risk factors for intra-operative cystotomy during TVT and whether this affects surgical outcome and morbidity. Charts of 340 women who underwent TVT were reviewed. Those who had a cystotomy during the procedure (cases) were compared with those without (controls) for the variables: age, race, parity, body mass index (BMI), TVT with or without other procedures, previous pelvic surgery, blood loss, length of catheter drainage, UTI, and voiding dysfunction. The t-test and chi-squared test were used and differences resulting in P < .05 were statistically significant. Cystotomy occurred in 49/340 TVT procedures (14.4%). Only those who had a history of abdominal hysterectomy and BMI greater than 26.5 were more likely to have a cystotomy (P = .05 and P = .001, respectively). Cases were more likely to go home with catheter drainage (P = .005). There was no increased risk of UTI or voiding dysfunction, nor was there a difference in surgical cure rate. Cystotomy does not seem to negatively affect the outcome of the TVT procedure.

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