**1. Introduction**

240 Urinary Incontinence

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vaginal tape and colposuspension for primary urodynamic stress incontinence:

Many factors are involved in the pathogenesis of stress urinary incontinence (SUI) and for several decades attempts have been made to design the best device for its treatment. Experience and research have led to important breakthroughs, but there is currently no 100% effective treatment devoid of complications. As treatments have changed, the materials and access routes have given way to complications not previously reported that have sometimes been fatal. ObGyns, urologists and urogynecologists that perform surgical procedures for urinary incontinence would like to have the best kit and none of the reported complications, but in actuality, everyone has such complications. Every surgeon wonders: What was the cause of this complication? How will it be resolved? How is it classified? For future patients, how can such a complication be prevented? There have been reports of erosion and/or extrusion of material in new kits or devices for urinary incontinence in the urethra, bladder, vagina and ureter; as well as bleedings during the surgical procedure with injury to the pelvic or vaginal vessels, suburethral hematomas, intestinal perforation, voiding dysfunction, nerve lesions, bladder perforation, infections and abscesses, de novo overactive bladder, pelvic pain, necrotizing fasciitis and even death.

For decades, different types of materials have been used, such as monofilament or multifilament mesh, micropore, macropore, silicone, polyester, polypropylene and gore-tex, and none of them is free of complications.

This chapter is an overview of the complications reported according to the device or kit used, the type of mesh, with reference to the classification of complications of the International Continence Society (ICS) and the International Urogynecological Association (IUGA) and the treatments used to resolve these complications. It is necessary to adequately follow the technical procedure, check the correct position of the patient´s legs, know the anatomy and receive periodical training.
