Tape related complications of the tension-free vaginal tape procedure.
OBJECTIVE
The tension-free vaginal tape (TVT) procedure is a recent modality for managing female stress urinary incontinence. While this procedure is rapidly gaining popularity worldwide, little has been written about its complications. We describe our experience with diagnosing and treating tape related complications following the TVT procedure.


METHODS
During the last 4 years 12 patients underwent and 1 is scheduled for additional surgery for complications resulting from the TVT. Another patient is only being observed. Their records were reviewed to retrieve data on presenting symptoms and signs, diagnostic tests, surgical procedures and outcomes.


RESULTS
One patient had tape erosion into the bladder, 5 had vaginal tape erosion (concomitant urethral obstruction in 1) and another 8 had an obstructed urethra. The more common presenting symptoms were persistent urethral pain, recurrent urinary tract infection, urgency, urge incontinence and vaginal discharge. A total of 12 patients required partial tape removal or tape incision, which was done transvaginally in 11. The remaining patient underwent cystotomy and excision of the intravesical part of an eroded tape. One patient is awaiting corrective surgery and 1 with asymptomatic vaginal erosion is only being observed. No formal urethrolysis was performed in any case. Mean followup after corrective surgery in 12 patients was 4.8 months (range 1 to 30), during which 10 remained continent and all 12 were symptom-free.


CONCLUSIONS
Urologists should be aware of the nature and symptoms of tape related complications associated with a TVT procedure for prompt diagnosis and appropriate postoperative management.
Tsivian
Alexander
A
Department of Urologic Survey, Edith Wolson Medical Center and Sackler Faculty of Medicine-Tel Aviv University, Holon, Israel. atsivian@hotmail.com
Kessler
Oded
O
Mogutin
Baruch
B
Rosenthal
Jonathan
J
Korczak
Doron
D
Levin
Samuel
S
Sidi
A Ami
AA
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D019736:Prostheses and Implants / Q000009:adverse effects*; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects*; D014621:Vagina