Abstract
Purpose: Stress urinary incontinence (SUI) is a common condition affecting up to 50% of women in their lifetime which can have a significant impact on daily activities due to anxiety and embarrassment. Surgical options for management include urethral bulking agents or slings (autologous rectus fascial sling [RFS] or synthetic mesh [TVT]). Pelvic mesh has come under global scrutiny in recent years due to complications. The aim of this study was to identify complication rates and rates of urinary retention after surgical intervention for SUI.
Methodology: A five-year prospective audit was undertaken of all patients who underwent surgical management of incontinence in public and private hospitals across the Canterbury, West Coast, South Canterbury and Wairarapa regions from 2018 to 2024. Complications (Clavien-Dindo classification) and rates of urinary retention were recorded and analysed.
Results: A total of 410 procedures were included for analysis. Post-surgery urinary retention occurred on 4 occasions (0.96%), all of which were post rectus fascial sling. Overall rates of complications were 23.2% for rectus fascial sling, 12.1% for retropubic mesh, and 2.4% for urethral bulking agents. Overall Clavien-Dindo complication rates less than grade 3 were 10.2%, and grade 3 or greater were 1.7%.
Conclusion: To our knowledge this is the first multi-centre report across both public and private hospitals to assess complications and rates of urinary retention post-SUI surgery in New Zealand. Our results suggest grade 3 or above complication rates post SUI surgery were low. Our results also suggest urinary retention was rare post SUI surgery and is more likely post rectus fascial sling than post retropubic mesh or urethral bulking agents.