title: Secondary Transobturator Tape Procedure after Combined Pelvic Organ Prolapse Repair.
abstract: A 66-year-old female who underwent a partial urethrectomy complained of severe incontinence due to intrinsic sphincter deficiency. Bone anchor surgical technique was performed, but in 3 years, serious pelvic organ prolapse had occurred. Consequently, anterior and posterior tension-free vaginal mesh operation was planned. Preoperative urodynamic examination predicted postoperative stress incontinence, and concurrent transobturator tape (TOT) surgery was performed. After 3 months, stress incontinence reoccurred, and secondary TOT was performed. Relapse was probably caused by dislocation of the first TOT towards the bladder neck. Thus, the secondary TOT was placed distal to the initial tape towards the external urethral meatus, and proper tension was applied. After the operation, stress incontinence was cured. Thus, a second TOT procedure, with proper positioning and tensioning, can effectively cure stress incontinence that occurs after an initial TOT procedure.
authors.affiliation: Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Tetsuichi
authors.initials: T
authors.lastname: Saito
authors.affiliation: Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Nishizawa
authors.affiliation: Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Masakuni
authors.initials: M
authors.lastname: Ishikawa
authors.affiliation: Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Shimojima
authors.affiliation: Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Oguchi
authors.affiliation: Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Hisanori
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yokoyama
authors.affiliation: Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Midori
authors.initials: M
authors.lastname: Ichino
authors.affiliation: Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Haruaki
authors.initials: H
authors.lastname: Kato
authors.affiliation: Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Ishizuka
keywords: anterior and posterior tension-free vaginal mesh; intrinsic sphincter deficiency; stress urinary incontinence; transobturator tape