A safe and simple solution for intravesical tension-free vaginal tape erosion: removal by standard transurethral resection.
OBJECTIVE
To report our experience with the successful removal of visible tension-free vaginal tape (TVT) by standard transurethral electroresection, as intravesical tape erosion after TVT is a rare complication, and removal can be challenging, with few cases reported.


METHODS
Five patients presenting with TVT erosion into the bladder were treated at our institutions from December 2004 to July 2007; all had standard transurethral electroresection. Their records were reviewed retrospectively to retrieve data on presenting symptoms, diagnostic tests, surgical procedures and outcomes.


RESULTS
The median (range) interval between the TVT procedure and the onset of symptoms was 17 (1-32) months. The predominant symptoms were painful micturition, recurrent urinary tract infection (UTI), urgency and urge incontinence. There were no complications during surgery. The storage symptoms and UTI resolved completely after removing the eroded mesh in all but one patient. Cystoscopy at 1 month after surgery showed complete healing of the bladder mucosa.


CONCLUSIONS
Although TVT erosion into the bladder is rare, persistent symptoms, particularly recurrent UTIs, must raise some suspicion for this condition. Standard transurethral electroresection seems to be a safe, simple, minimally invasive and successful treatment option for TVT removal.
Huwyler
Mirjam
M
Department of Urology, University of Bern, Bern, Switzerland.
Springer
Johannes
J
Kessler
Thomas M
TM
Burkhard
Fiona C
FC
D000368:Aged; D015653:Cystectomy / Q000379:methods; D020878:Device Removal / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D053825:Suburethral Slings / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000473:pathology / Q000601:surgery*; D014552:Urinary Tract Infections / Q000209:etiology*; D014555:Urination Disorders / Q000209:etiology*