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The sling procedures are the gold standard for SUI treatment. They are highly effective but not free from complications. The most common adverse effect for the surgery with the implant insertion is: overactive bladder occurring de novo after the surgery, voiding dysfunctions, urine retention, and unsatisfactory treatment outcome. The most important question that arises after 20 years of sling procedures is how to manage the complications and what can be offered to complicated patients. The above review summarises the ultrasound findings in complicated cases and shows the scheme of management of the clinical problems concerning the tape location in suburethral region.

Erratum to: Int Urogynecol J (pp 795—800, issue 192_21_7) DOI10.1007/s00192-010-1119-z The color figures appeared correctly online, but were mistakenly printed in black and white. They are reproduced in color here. Fig. 1 Outcome 48 months after TVT insertion according to tape position relative to the urethra and tape distance from the urethra. The optimal tape position, which was found to be at 50–80% of the urethral length with a tape–urethra ... Fig. 2 Changes in tape shape in Groups I–III (tape functionality) by baseline tape position at 48-month follow-up. The groups are explained in the “Patients and methods” section Fig. 3 Patients were assigned to the groups based on tape functionality at the 6-month postoperative follow-up. The figure shows cure and complication rates by group at 48 months

Introduction and hypothesis This study evaluates the relevance of the tape position and change in shape (tape functionality) under in vivo conditions for mid-term outcome. Methods Changes in the sonographic tension-free vaginal tape (TVT) position relative to the percentage urethral length and the tape–urethra distance were determined after 6 and 48 months in 41 women with stress urinary incontinence. Results At 48 months, 76% (31/41) of women were cured, 17% (7/41) were improved, and 7% (3/41) were failures. Disturbed bladder voiding was present in 12% (5/41), de novo urge incontinence in 7% (3/41). The median TVT position was at 63% of urethral length. Median tape–urethra distance was 2.7 mm, ranging from 2.9 mm in continent patients without complications to 1.1 mm in those with obstructive complications. Patients with postoperative urine loss had a median distance of 3.9 mm. The tape was stretched at rest and C-shaped during straining in 15 of 41 women (37%) at 48 months (all continent). Patients with this tape functionality at 6 months were also cured at 48 months in 86% of cases (19/22), and only 14% (3/22) showed recurrent incontinence. Conclusions Mid-term data suggest an optimal outcome if the tape is positioned at least 2 mm from the urethra at the junction of the middle and distal thirds. Patients with optimal tape functionality at 6 months are likely to show mid-term therapeutic success.