Tension-free Vaginal Tapes and Pelvic Nerve Neuropathy.
Obturator nerve neuropathies after tension-free vaginal tape or transobturator tape are considered to be caused by nerve trauma, although it is unclear whether these are accidents or whether these injuries are inherent to the procedure of tape insertion. Two cases show that obturator nerve neuropathy can occur after tension-free vaginal tape without direct trauma to the obturator nerve possibly as a consequence of excessive fibrotic reaction or persisting low-grade inflammation. PubMed Entrez, Cochrane Library, and up-to-date databases were searched for obturator and pudendal neuropathy and for neuropathies associated with tension-free vaginal tape-transobturator tape and the symptoms, diagnosis, and therapy of the pudendal and obturator nerve neuropathies are reviewed. Based on data, our experience, and data available in literature, we can conclude that, if conservative obturator nerve block confirms the diagnosis of obturator nerve neuropathy and symptoms recur shortly thereafter, a laparoscopic neurolysis can be proposed as therapy.
Corona
Roberta
R
Department of Obstetrics and Gynecology, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium. coronaroberta@gmail.com
De Cicco
Carlo
C
Schonman
Ron
R
Verguts
Jasper
J
Ussia
Anastasia
A
Koninckx
Philippe R
PR
D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects; D006801:Humans; D007001:Hypogastric Plexus / Q000293:injuries*; D008875:Middle Aged; D020422:Mononeuropathies / Q000209:etiology; D009408:Nerve Compression Syndromes / Q000209:etiology* / Q000601:surgery; D009776:Obturator Nerve / Q000293:injuries*; D017773:Pelvic Floor / Q000294:innervation / Q000601:surgery; D053825:Suburethral Slings / Q000009:adverse effects*; D013520:Urologic Surgical Procedures / Q000009:adverse effects