Transurethral resection of transvaginal tape.
Urethral erosion is an uncommon complication after tension-free vaginal tape (TVT) procedure. However, management is a challenge and morbidity significant because of the necessity to incise the urethra to gain access to the material. This is a report of a case of transurethral resection of such mesh. A 77-year-old women presented at 7 months postoperatively with complaints of incomplete emptying and persistent incontinence. Urodynamic testing and cystoscopy revealed intrinsic sphincter deficiency, an elevated post void residual and erosion of the TVT tape into the urethral lumen. The tape was removed without any incisions via an operative cystoscope and hysteroscopic scissors. All urinary symptoms resolved. Partial urethral transection can be managed successfully with transurethral resection of the material. This diagnosis should be considered in patients with incomplete emptying and recurrent incontinence.
McLennan
Mary T
MT
Department of Obstetrics, Gynecology and Women's Health, Division of Urogynecology/Reconstructive Pelvic Surgery, St. Louis University School of Medicine, 6420 Clayton Rd, Suite 290, St. Louis, MO 63117, USA. mclennam@slucare1.sluh.edu
D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D011183:Postoperative Complications; D019736:Prostheses and Implants / Q000009:adverse effects; D011475:Prosthesis Failure; D013526:Surgical Mesh / Q000009:adverse effects; D014522:Urethral Diseases / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology / Q000601:surgery; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects; D014621:Vagina / Q000601:surgery*