title: Bladder perforation after TVT-Secur procedure: how secure is TVT-Secur?
abstract: BACKGROUND
  A rare but challenging complication of midurethral tape procedures is perforation of the tape through the bladder wall.
  
  
  METHODS
  We saw three patients in whom unrecognized bladder perforation during TVT-Secur procedures occurred. It took an average follow-up time of 11 months before the bladder perforations were identified by introital ultrasound. Complete excision of the mesh was achieved endoscopically (TURP resectoscope) and/or by traditional vaginal tape removal techniques. Following tape removal, there has been no recurrence of urinary tract infections, and the irritative voiding symptoms have resolved in all three cases.
  
  
  CONCLUSIONS
  Bladder perforation after mini-sling procedures can be managed using a combined transurethral/vaginal approach. This technique is minimally invasive, safe, and successful. Careful introital ultrasound should be performed in patients presenting with new lower urinary tract symptoms after sling surgery to avoid delays in diagnosing bladder perforation.
authors.affiliation: Department of Gynecology and Obstetrics, Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland.
authors.forename: Irena
authors.initials: I
authors.lastname: Zivanovic
authors.forename: Jacek
authors.initials: J
authors.lastname: Kociszewski
authors.forename: Jakob
authors.initials: J
authors.lastname: Eberhard
authors.forename: Volker
authors.initials: V
authors.lastname: Viereck
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D019919:Prosthesis Implantation / Q000009:adverse effects*; D053825:Suburethral Slings / Q000009:adverse effects*; D013526:Surgical Mesh / Q000009:adverse effects*; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000293:injuries*; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014552:Urinary Tract Infections / Q000209:etiology