Simple sling resection and a second, intermediate polypropylene mesh for treatment of vaginal tape protrusion concurrent with recurrent urinary stress incontinence after TVT procedure

• Published in: The journal of obstetrics and gynaecology research 2007-10, Vol.33 (5), p.739-742
• Main Authors: Lo, Tsia‐Shu, Lee, Shu‐Jane
• Format: Article
• Language: English
• Subjects: Female; Humans; Middle Aged; stress urinary incontinence; Suburethral Slings; tension‐free vaginal tape; ultrasonography; Urinary Incontinence, Stress - surgery; Urogenital Surgical Procedures - methods
• ISSN: 1341-8076; 1447-0756
• DOI: 10.1111/j.1447-0756.2007.00643.x

The tension‐free vaginal tape (TVT) procedure is a simple, effective and minimally invasive method for the surgical treatment of urodynamic stress incontinence (USI). Yet, complications such as mesh protrusion and recurrent urinary leakages after TVT have been reported. A case of recurrent USI complicated with vaginal mesh protrusion following a TVT procedure was referred. Video‐urodynamics and introital ultrasonography confirmed that the recurrence of USI was secondary to mal‐position of the protruded TVT. A simple salvaging procedure was carried out. The mal‐positioned distal protruded TVT was resected and a second intermediate piece of polypropylene (Prolene) mesh was replaced at mid‐urethra. The operation time was short and blood loss was minimal. The patient was objectively continent at 6 months follow‐up with no defect of healing. Considering the cost‐effectiveness and invasiveness of the surgeries, the method of inserting an intermediate mesh is clinically useful.