title: Vaginal revision of intravesical tension-free vaginal tape 44 h after initial placement: a case report.
abstract: Unintentional cystotomy is a known complication of the tension-free vaginal tape procedure and is commonly diagnosed intraoperatively. Delayed diagnosis does occur and various reparative techniques have been described, some requiring laparotomy with intentional cystotomy and repair. We report a case where a 46-year-old woman underwent vaginal reconstructive surgery including placement of a tension-free vaginal tape, which was complicated by unilateral cystotomy. A delayed diagnosis of intravesical tape placement was made requiring reoperation. The patient underwent a minimally invasive transvaginal procedure for removal and immediate replacement of the malpositioned arm of the tape. We conclude that a transvaginal approach may be an acceptable technique for revision and replacement of the tension-free vaginal tape where cystotomy is identified within 44 h after the initial procedure. With this technique, a more invasive surgery including laparotomy with cystotomy might successfully be avoided.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Urogynecology and Reconstructive Pelvic Surgery, UMass Memorial Medical Center, 119 Belmont Street, Worcester, MA 01605, USA. labinl@ummhc.org
authors.forename: Lisa C
authors.initials: LC
authors.lastname: Labin
authors.forename: Abraham N
authors.initials: AN
authors.lastname: Morse
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Young
mesh_terms: D020684:Cystoscopes; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011475:Prosthesis Failure; D012086:Reoperation; D053825:Suburethral Slings / Q000009:adverse effects*; D001743:Urinary Bladder / Q000293:injuries*; D013520:Urologic Surgical Procedures