[Management of erosive complications after tension-free vaginal tape procedure].
OBJECTIVE
To describe the management of patients with an erosive complication after tension free vaginal tape. To establish a diagnostic approach, describe the results on symptoms and continence after a conservative surgery.


METHODS
Retrospective descriptive study of 38 patients supported for complications after suburethral synthetic sling. We have diagnosed 12 erosions vaginal and five bladder erosions. Patients have been treated from a recovery surgery according to a conservative approach (partial resection or endoscopic section).


RESULTS
Of the 12 patients with a vaginal erosion, 10 expressed symptoms in relation with their erosion. After partial resection, eight patients (80% of patients with symptomatic erosion) did not have more complain. Of these, 50% were continent, the other with mostly a slight recurrence accessible to a second suburethral sling. First endoscopic section was a minimally invasive option for bladder erosion. However, an only cystoscopic approach seemed to be not sufficient to cut the sling as far as possible. After section, two patients have been treated from a laparotomy with bladder dissection, one for immediate outcome unsatisfactory, the other for reccurent symptoms. The results for continence were excellent as the suburethral portion was not resected.


CONCLUSIONS
Our study showed the importance of regular clinical surveillance, feasibility and the relative success of this conservative approach. The technical feasability and the increasing number of patients must not forget to respect good indication and rigorous technique. These complications invite us to moderate our indications especially for young patients.
Lapouge
O
O
Service de chirurgie urologique, hôpital Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France. olapouge@aol.com
Bram
R
R
Hocke
C
C
Ballanger
P
P
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D053825:Suburethral Slings / Q000009:adverse effects*; D001745:Urinary Bladder Diseases / Q000209:etiology / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000601:surgery; D014623:Vaginal Diseases / Q000209:etiology / Q000601:surgery*