Simple sling resection and a second, intermediate polypropylene mesh for treatment of vaginal tape protrusion concurrent with recurrent urinary stress incontinence after TVT procedure.
The tension-free vaginal tape (TVT) procedure is a simple, effective and minimally invasive method for the surgical treatment of urodynamic stress incontinence (USI). Yet, complications such as mesh protrusion and recurrent urinary leakages after TVT have been reported. A case of recurrent USI complicated with vaginal mesh protrusion following a TVT procedure was referred. Video-urodynamics and introital ultrasonography confirmed that the recurrence of USI was secondary to mal-position of the protruded TVT. A simple salvaging procedure was carried out. The mal-positioned distal protruded TVT was resected and a second intermediate piece of polypropylene (Prolene) mesh was replaced at mid-urethra. The operation time was short and blood loss was minimal. The patient was objectively continent at 6 months follow-up with no defect of healing. Considering the cost-effectiveness and invasiveness of the surgeries, the method of inserting an intermediate mesh is clinically useful.
Lo
Tsia-Shu
TS
Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taoyuan, Taiwan. 2378@adm.cgmh.com.tw
Lee
Shu-Jane
SJ
D005260:Female; D006801:Humans; D008875:Middle Aged; D053825:Suburethral Slings; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013519:Urogenital Surgical Procedures / Q000379:methods*