Surgical treatment using the mid-urethral tape has become a gold standard in the treatment of stress urinary incontinence in women [1]. Despite the careful development of this method, complications can occur.  The most common post – operative problems are voiding dysfunction and overactive bladder (OAB). The occurrence of these complications can cause the patient’s considerable dissatisfaction with mid-urethral tape procedure [2, 3]. The aim of this study was to investigate the effectiveness of the treatment of lower urinary tract symptoms (LUTS) after tape revision (incision, removing the tape up to 1 cm, or removing all available part of the tape) based on the subjective assessment of patients.

A group of 90 patients, suffering from LUTS after anti–incontinence surgery using a synthetic tension-free vaginal tape, was included in this study. 53 (59%) patients after transobturator (TOT), 1(1,1%) after TOT and retropubic (TVT), 35 (38,9%) after TVT and 1 (1,1%) after miniarc tape as primary surgery. The mean age of patients, who underwent primary mid-urethral tape surgery was 58.2 and tape revision was 64.6. The mean time from primary surgery to our control was 6.8 years and from tape revision to the control – 11.7 months. Before and after the tape revision the patients completed the Urogenital Distress Inventory (UDI-6) short form, a questionnaire of severity of LUTS (pelvic pain, frequency, nocturia, urgency, incontinence, SUI, hesitancy, dysuria, recurrent UTI) ranging from 0 to 3 (0: not at all, 1: slight, 2: moderate, 3: severe complaints). Visual analogue scale (VAS) of subjective assessment of lower urinary tract function ranging from 0 to 100 (0: very bad, 100: perfect function) was also rated. The tape localization and residual volume was assessed by introital ultrasound [3]. We always removed the tape if it was displaced (lower edge above 37.5% of the urethral length) and in the case of voiding disorders with residual urine above 50 ml together with recurrent urinary tract infections (UTI). We compared the subjective assessments of patients for LUT complaints (pelvic pain, frequency, nocturia, urgency, incontinence, stress urinary incontinence, hesitancy, dysuria, post – void residuals, recurrent urinary tract infection, UDI-6, and VAS of subjective assessment of lower urinary tract function) before and after the tape revision. The Wilcoxon rank sum test was used to compare continuous data. This was a retrospective study with a prospective component.

All analysed symptoms improved after tape revision, except for SUI. Also, the patient satisfaction with the lower urinary tract function rated on the VAS after the tape revision was better. The data were statistically significant (significance level a= 0.05). The tape revision procedure was not associated with any serious complications.

Patients after tape revision surgery assessed the quality of life as better than before the secondary surgery.
Despite the fact that 51% of patients relapsed from stress urinary incontinence, only 24.4% decided to undergo surgery again using polypropylene tape.
Martius flap interposition was performed in 1 patient.
OAB was persistent in 40% of patients, but only 7.8% needed pharmacological treatment.

A mid-urethral polypropylene tape should be revised if bothersome symptoms appeared after the surgery.

Araklitis G, Baines G, Da Silva AS, et al. Healthcare professional’s choice for surgical management of stress urinary incontinence in a U. K. tertiary hospital. Eur J Obstet Gynecol Reprod Biol 2021;263:7-14.
Rautenberg O, Kociszewski J, Welter J, et al. Ultrasound and early tape mobilisation – a practical solution for treating postoperative voiding dysfunction. Neurourol Urodyn 2014;33:1147-1151.
Pawlaczyk A, Waz P, Matuszewski M. Introital ultrasound in the diagnosis of lower urinary tract symptoms following anti-incontinence surgery using a synthetic midurethral tape. Int Urogynecol J 2019;30:1503-1508.