title: Removing a misplaced retropubic midurethral sling from the urethra and bladder neck using ear, nose, and throat instruments.
abstract: BACKGROUND
  The retropubic tension-free vaginal tape (TVT) procedure is a common procedure with complications attributed to voiding dysfunction, bladder perforation, and bleeding. We present a case of successful removal of a retropubic midurethral sling from the urethra using a head lamp and a combination of ear, nose, and throat instruments.
  
  
  METHODS
  A 63-year-old woman presented to our clinic with the symptom of gross hematuria after having undergone a TVT procedure. On office cystoscopy, the sling was noted to be placed within the urethral mucosa. Removal of the mesh was performed using a nasal speculum, left and right ethmoid scissors, left and right Blakesley graspers, and a head lamp to dissect the mesh directly out of the urethra.
  
  
  CONCLUSIONS
  The utilization of ear, nose, and throat tools allowed us to resect the intraurethral mesh without necessitating incision of the urethral sphincter.
authors.affiliation: Center for Urogynecology and Pelvic Reconstructive Surgery, Obstetrics, Gynecology & Women's Health Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Ellen R
authors.initials: ER
authors.lastname: Solomon
authors.forename: J Eric
authors.initials: JE
authors.lastname: Jelovsek
mesh_terms: D020878:Device Removal / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010036:Otolaryngology / Q000295:instrumentation; D053825:Suburethral Slings / Q000009:adverse effects; D013526:Surgical Mesh / Q000009:adverse effects; D014521:Urethra / Q000601:surgery; D001743:Urinary Bladder / Q000601:surgery; D013520:Urologic Surgical Procedures / Q000295:instrumentation*