Tension-free vaginal tape operation: Results of the Austrian registry

OBJECTIVE: To assess the use of and perioperative complications associated with the tension-free vaginal tape operation with a central registry. METHODS: Fifty-five gynecology units completed questionnaires on patients u ndergoing the tension-free vaginal tape operation. Information was collecte d on patient, surgical, and postoperative data. RESULTS: A total of 2795 patients were entered. Overall, 773 patients (28%) had undergone previous surgery for incontinence or prolapse; 1640 (59%) te nsion-free vaginal tapes were performed as isolated operations, and 1155 (4 1%) were done in combination with other procedures. The median operating ti me for tension-free vaginal tapes alone was 30 minutes (range 10-120). Of t he isolated tension-free vaginal tapes, 727 (44%) were performed with local , 711 (43%) with regional, and 193 (12%) with general anesthesia. In patien ts undergoing tension-free vaginal tape only, postoperative bladder drainag e was obtained with intermittent catheterization in 389 (24%) patients, an ind-welling urethral catheter in 1032 (63%), and a suprapubic catheter in 1 43 (9%). The bladder perforation rate was 2.7% overall (n = 75) and higher in patients with than in those without previous surgery (4.4% compared with 2.0%, P = .01). There were four bladder perforations (3.3%) among the 120 patients with previous colposuspension. Most patients undergoing tension-fr ee vaginal tape only were able to void the next day (range 0 to over 64). A total of 68 patients (2.4%) required reoperation for reasons related to th e tape (39 to loosen, remove, or cut the tape, or to place a suprapubic cat heter, 19 for hematoma, one for bowel injury). CONCLUSION: The tension-free vaginal tape has become a frequently performed operation in Austria. There are considerable variations in clinical practi ce. The risk of bladder perforation was increased in patients with previous surgery. Severe complications were rare. (Obstet Gynecol 2001;98:732-6. (C ) 2001 by the American College of Obstetricians and Gynecologists).