Complications

Complication
Timeframe
Likelihood
short term
high

Urinary tract infection and urinary retention are the most commonly reported adverse effects of peri-urethral bulking agents.[144]

short term
high

The incidence of urinary tract infection and urinary retention is significantly higher, compared to placebo, in people with overactive bladder treated with botulinum toxin type A.[124]​ Patients should be counselled about the possible need for temporary self-catheterisation.​[1]

short term
medium

Treatment involves prolonged bladder drainage followed by bladder challenge or clean intermittent self-catheterisation.

short term
medium

Treatment is a course of antibiotics, with sensitivities guiding choice.

short term
low

Immediate recognition by cystoscopy and remedied intraoperatively. May need prolonged bladder drainage.

short term
low

Transfusion of blood products if indicated. Rarely necessitates exploration.

short term
low

Prompt clinical recognition or with radiological studies. Exploration and repair of enterotomy.

short term
low

Occurs in <5%.[146]

long term
medium

Anticholinergic drug use is associated with increased dementia incidence and cognitive decline in observational studies; however, it is unclear whether the observed associations between anticholinergic drug use and dementia is a causal relationship or reflects risk factors or early symptoms of dementia (such as bladder instability).[116][117]​​​ Caution is recommended when using anticholinergics in older or frail patients, and use should be avoided in patients with dementia, cognitive impairment, or delirium.[116][117]​​[118]

long term
medium

3.3% to 30% of slings need revision or removal.[101][148]

variable
high

Pain at the implant or lead site is common in the perioperative period. Occasionally, the pocket containing the impulse generator may need to be revised.[145]

variable
medium

Occurs in 2% to 37% of slings and 4% to 11% of tension-free tapes.[147]

variable
low

There is a low risk of erosion with the use of peri-urethral bulking agents.[129][144]

variable
low

Delayed closure of vaginal wall dehiscence if signs of infection and treatment with appropriate antibiotic regimen.

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