Urethrovaginal fistula--a rare complication after the placement of a suburethral sling (IVS).
A sixty-year-old woman with stress urinary incontinence had undergone a placement of an IVS (Tyco Health Care UK) in another hospital in February 2003. Seventeen months after the procedure, she complained about a suppurative discharge from the vagina and a recurrent severe stress urinary incontinence. The gynecological examination revealed an erosion of the sling into the vagina and a large urethrovaginal fistula bordered by granuloma. After removal of the sling, the urethrovaginal fistula was closed using a vaginal flap. A subsequent conservative treatment regime with duloxetine and pelvic floor training improved the stress urinary incontinence to the patient's satisfaction.
Reisenauer
Christl
C
Department of Obstetrics and Gynecology, University of Tuebingen, Calwerstrasse 7, 72076, Tuebingen, Germany. christl.reisenauer@med.uni-tuebingen.de
Wallwiener
Diethelm
D
Stenzl
Arnulf
A
Solomayer
Franz-Erich
FE
Sievert
Karl-Dietrich
KD