Predictive Value of Intraoperative Hematuria for Bladder Rupture Caused by Passing Tunnlers during Suburethral Sling for Stress Urinary Incontinence

Bladder wall perforation is one of important complications in suburethral sling procedures. The aim of the present study is to assess predictive value of intraoperative hematuria for bladder rupture caused by passing tunnlers during suburethral sling.Patients and 250 females with stress urinary incontinence were enrolled in this cross-sectional study from October 2004 to July 2008.The ICIQ-SF questionnaire was filled in for all the subjects, and urogynecological examinations including assessment of pelvic organs prolaps and stress test were performed on them. All of the cases underwent IVS surgery and bladder wall perforation was assessed in all patients with or without intraoperative hematuria by cystoscopy. Statistic analysis based on acquired data was done afterward. The mean age of the patients was 41 ± 6.3 years. 15 out of 250 cases had intraoperative hematuria during the surgery, and in 13 cases bladder wall perforation was seen in cystoscopic control. On the other hand, there were 2 cases of hematuria without bladder wall perforation. Sensitivity, specificity and positive predictive value were 86.6%, 96.6% and 100% respectively. Intraoperative hematuria can be considered as a predictive test for bladder wall perforation, and cystoscopic evaluation is necessary for these patients.