Transurethral holmium laser intravesical tape excision following TVT procedure: results from seven patients in a 12-month follow-up
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Introduction and hypothesis
The aim of this study is to evaluate the efficacy and the safety of the holmium:YAG laser for intravesical mesh excision in female patients with urinary bladder erosion complicated tension-free vaginal tape (TVT) procedure.
Between June 2, 2008 and December 31, 2009, seven patients who underwent laser excision of an intravesically protruding tape were followed up every 3 months for a total period of 1 year by disease-specific questionnaires, physical examination, cough stress test, urine analysis, urine bacterial culture, ultrasound and uroflowmetry. Filling cystometry was offered preoperatively and at the 3rd month, while cystoscopy was offered preoperatively and at the 1st month. The presenting symptoms were dysuria, urgency, hematuria, and recurrent lower urinary tract infections. Holmium laser was used for ablation and removal of the tape. The postoperative period was uneventful.
There was a substantial improvement in the urgency status, in the maximum flow rate (Q max) from 11.29 ml/s to 19.43 ml/s, in the voided volume (VV) from 185 ml to 251.43 ml and in the maximum cystometric capacity (C) from 237.86 ml to 310.64 ml pre- and postoperative, respectively.
Holmium laser ablation represents a simple, safe and efficacious procedure to manage intravesical mesh complications following TVT procedure.
KeywordsTVT Holmium:YAG laser tape excision Bladder erosion Urodynamic parameters
Conflict of interest
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- 7.Charalambous S, Tountziaris C, Karapanagiotidis C, Thamnopoulos C, Papathanasiou A, Rombis V (2008) A simple technique for intravesical tape removal. Pelviperineology 27:26–27Google Scholar
- 10.Kielb S, Clemens J (2004) Endoscopic excision of intravesical tension free vaginal tape and polypropylene suture after anti-incontinence procedures. J Urol 174:1306–1307Google Scholar
- 11.Panayi DC, Khullar V (2008) Quality of life questionnaires in evaluating overactive bladder. Eur Uro Rev 3(1):59–61Google Scholar
- 17.Zullo MA, Plotti F, Calcagno M, Marullo E, Palaia I, Bellati F, Basile S, Muzii L, Angioli R, Panici PB (2007) One year follow-up of tension free vaginal tape (TVT) and transobturator suburethral tape from inside to outside (TVT-O) for surgical treatment of female stress urinary incontinence: a prospective trial. Eur Urol 51:1376–1382PubMedCrossRefGoogle Scholar
- 19.Haab F, Sananes S, Amarenco G, Ciofu C, Uzan S, Gattengo B, Thibault P (2001) Results of tension free vaginal tape procedure for the treatment of type II stress incontinence at a minimum follow up of 1-year. J Urol 165:159:62 Google Scholar
- 21.Ward KL, Hilton P, Browing J (2000) A randomised trial of colposuspension and tension free vaginal tape for primary genuine stress incontinence. Neurourol Urod 19:386Google Scholar
- 22.Doumouchtsis S, Lee F, Bramwell D, Fynes M (2011) Evaluation of holmium laser for managing mesh/suture complications of continence surgery. BJU Int. doi: 10.1111/j.1464-410X.2010.10012.x
- 24.Ulmsten U, Johnson P, Rezapour M (1999) A three-year follow up of tension free vaginal tape for surgical treatment of female stress urinary incontinence. Br J Obstet Gynaecol 160:345–350Google Scholar