Innovation for Pelvic Health

Incontinence following prostatectomy can be a devastating complication significantly impacting quality of life. The prevalence of post-prostatectomy urinary incontinence (PPI) varies from 2.5%–87%, with 2%–10% reported in more recent series.1,2 Incontinence can also occur in 1% of patients undergoing surgical treatment for benign prostatic hypertrophy. 1

Due to its efficacy, safety, and relative simplicity, the synthetic mid-urethral sling procedure has emerged as one of the mainstays
of surgical therapy for female stress urinary incontinence. The transobturator approach to placing mid-urethral slings has recently been marketed as safer than the retropubic approach due to avoidance of entry into the retropubic space. However, accumulated experience has demonstrated that significant complications are possible with both techniques. The purpose of this review is to summarize the rates, etiology, and management of the most common complications encountered with synthetic mid-urethral slings and to compare, based on recent evidence, complication rates of the retropubic and transobturator approaches to sling placement.