Trans vaginal tape readjustment after unsuccessful tension-free vaginal tape operation.
OBJECTIVE
This study is aimed at evaluating a new surgical technique to deal with tension-free vaginal tape (TVT) failure. The TVT operation, described by Ulmsten in 1995, is based on a mid urethral Prolene tape support. TVT is accepted as an easy-to-learn and safe minimal invasive surgical technique. Yet, as with other surgical methods for correction of female urinary stress incontinence, therapeutic failures occur with TVT also.


METHODS
Described here is a new approach for addressing this issue. Out of 344 women who underwent TVT and who were followed for up to 55 months, four (1.2%) requested to be reoperated on the grounds of a diagnosis of operative failure. These four women were treated by trans vaginal readjustment of the tape.


RESULTS
Three out of the four reoperated patients reported subjective continence, subsequently confirmed clinically. The fourth patient, although suffering residual minor urinary leakage, declined further interventions.


CONCLUSIONS
The readjustment technique seems effective, easy, and safe for the treatment of failed TVT operations. More experience is needed prior to suggesting this technique as a recommended approach.
Neuman
Menahem
M
Urogynecology, Department of Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel. neuman@szmc.org.il
D000328:Adult; D005260:Female; D006801:Humans; D012086:Reoperation; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures; D014621:Vagina / Q000601:surgery*