[Proximal urethra portion perforation during TVT-O in a patient with urethral deviation secondary to previous failed Burch surgery].
A 59 years old woman with laparoscopic Burch made during 2003 in another hospital. During 2006, the patient is evaluating in our center for a persistent urinary incontinence, the urodynamic study demonstrated stress urinary incontinence type II and overactive bladder without obstruction evidences. A TVT-O (tension-free vaginal tape obturador in-out route) was made, nevertheless when the right branch was passed blood was observed in the Foley catheter. A cystoscopy showed an important deviation of urethra and the tape through urethra in the proximal portion. The right branch went again inserted taking the necessary precautions. Two days after surgery the Foley catheter was removed and the stress urinary incontinence symptoms disappeared. The urge incontinence symptoms disappeared with the pharmacalogical treatment (Tolterodine 2 mg/day). We believe that the urethral deviation caused by a technically deficient laparoscopic Burch was the reason for the urethral perforation during the TVT-O.
Ricci Arriola
Paolo
P
Unidad de Uroginecología y Cirugía Vaginal de Clínica Las Condes, Santiago, Chile. pricci@clinicalascondes.cl
Solà Dalenz
Vicente
V
Pardo Schanz
Jack
J
D005260:Female; D006801:Humans; D008875:Middle Aged; D019919:Prosthesis Implantation / Q000009:adverse effects*; D053825:Suburethral Slings / Q000009:adverse effects*; D017211:Treatment Failure; D014521:Urethra / Q000293:injuries*; D014550:Urinary Incontinence, Stress / Q000601:surgery