title: Martius graft for TOT extrusion: a case series.
abstract: BACKGROUND
  The management of mid-urethral tape extrusion is inconsistent. We believe that we present here the first case series detailing the use of the Martius graft for trans-obturator tape (TOT) extrusion.
  
  
  METHODS
  Five women had a Martius graft for TOT extrusion. Data were obtained retrospectively from case notes and a review postoperatively to investigate the results in the short and intermediate term.
  
  
  RESULTS
  All extrusions were greater than 1 cm in diameter and situated between the midline and the lateral vaginal sulcus. In 3 women the tape extrusion was discovered at 6-12 weeks postoperatively and 2 presented with symptoms again after 12 months. Following the Martius graft, there was no ipsilateral recurrence of tape extrusion or exposure. Postoperatively, 2 women received oral antibiotics. Two women developed de novo sexual problems, which had resolved at follow-up.
  
  
  CONCLUSIONS
  It is promising that all the tape extrusions were successfully treated with a Martius Graft, thus preserving tape function. There was a high incidence of minor complications initially, but there was minimal long-term morbidity and no cosmetic dissatisfaction. We believe that testing this proposition in a larger case series will provide better evidence.
authors.affiliation: Royal Victoria Infirmary, Newcastle-Upon-Tyne, NE1 4LP, UK. amortimer@doctors.org.uk.
authors.forename: Alexander
authors.initials: A
authors.lastname: Mortimer
authors.affiliation: James Cook University Hospital, Middlesbrough, TS4 3BW, UK.
authors.forename: Aethele
authors.initials: A
authors.lastname: Khunda
authors.affiliation: Friarage Hospital, Northallerton, DL6 1JG, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Ballard
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D011475:Prosthesis Failure; D012189:Retrospective Studies; D053825:Suburethral Slings / Q000009:adverse effects*; D014550:Urinary Incontinence, Stress / Q000601:surgery*
keywords: Erosion; Extrusion; Martius graft; Trans-obturator tape