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International Urogynecology Journal

, Volume 23, Issue 6, pp 769–777 | Cite as

Transurethral holmium laser intravesical tape excision following TVT procedure: results from seven patients in a 12-month follow-up

  • Vasileios I. SakalisEmail author
  • Anastasia Chr. Gkotsi
  • Argyrios Triantafyllidis
  • Apostolos Giouris
  • Stavros Charalambous
Original Article

Abstract

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.

Methods

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.

Results

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.

Conclusions

Holmium laser ablation represents a simple, safe and efficacious procedure to manage intravesical mesh complications following TVT procedure.

Keywords

TVT Holmium:YAG laser tape excision Bladder erosion Urodynamic parameters 

Notes

Conflict of interest

None.

Supplementary material

ESM 1

(AVI 11362 kb)

References

  1. 1.
    Petros PE, Ulmsten UI (1990) An integral theory of female urinary incontinence. Experimental and clinical considerations. Acta Obstet Gynecol Scand Suppl 153:7–31PubMedGoogle Scholar
  2. 2.
    Ulmsten U, Henriksson L, Johnson P, Varhos G (1996) An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 7(2):81–85PubMedCrossRefGoogle Scholar
  3. 3.
    Roupret M, Misrai V, Vaessen C, Cour F, Haertig A, Kastler EC (2010) Laparoscopic surgical complete sling resection for tension-free vaginal tape related complications refractory to first line conservative management: a single center experience. Eur Uro 58:270–274CrossRefGoogle Scholar
  4. 4.
    Abouassly R, Steinberg JR, Lemieux M (2004) Complications of tension free vaginal tape surgery: a multi-institutional review. BJU Int 94:110–113CrossRefGoogle Scholar
  5. 5.
    Daneshgari F, Kong W, Swartz M (2008) Complications of mid urethral slings: important outcomes for future clinical trials. J Urol 180:1890–1897PubMedCrossRefGoogle Scholar
  6. 6.
    Goldman HB (2011) Urethrolysis. Urol Clin North Am 38(1):31–37PubMedCrossRefGoogle Scholar
  7. 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
  8. 8.
    Volkmer BG, Nesslauer T, Rinnab L (2003) Surgical intervention for complications of the tension free vaginal tape procedure. J Urol 169:570–574PubMedCrossRefGoogle Scholar
  9. 9.
    Jorion JL (2002) Endoscopic treatment of bladder perforation after tension free vaginal tape procedure. J Urol 168:197PubMedCrossRefGoogle Scholar
  10. 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. 11.
    Panayi DC, Khullar V (2008) Quality of life questionnaires in evaluating overactive bladder. Eur Uro Rev 3(1):59–61Google Scholar
  12. 12.
    Weber AM, Abrams A, Brubaker L, Cundiff G, Davis G, Dmochowski GG, Fischer J, Hull T, Nygaard I, Weidner AC (2001) The standardization of terminology for researchers in female pelvic floor disorders. Int Urogynecol J 12:178–186CrossRefGoogle Scholar
  13. 13.
    Wollin TA, Denstedt JD (1998) The holmium laser in urology. J Clin Laser Med Surg 16(1):13–20PubMedGoogle Scholar
  14. 14.
    Giri SK, Sil D, Narasimhulu G, Flood HD, Skehan M, Drumm J (2007) Management of vaginal extrusion after tension-free vaginal tape procedure for urodynamic stress incontinence. J Urol 69(6):1077–1080CrossRefGoogle Scholar
  15. 15.
    Zinner NR (1998) Clinical aspects of detrusor instability and the value of urodynamics. Eur Urol 34:16–19PubMedCrossRefGoogle Scholar
  16. 16.
    Waltregny D, de Leval J (2009) The TVT-obturator surgical procedure for the treatment of female stress urinary incontinence: a clinical update. Int Urogynecol J Pelvic Floor Dysfunct 20:337–348PubMedCrossRefGoogle Scholar
  17. 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
  18. 18.
    Zugor V, Labanaris A, Rezaei-Jafari M, Hammerer P, Dembowski J, Witt J, Wucherpfennig W (2010) TVT vs. TOT: a comparison in terms of continence results, complications and quality of life after a median follow-up of 48 months. Int Urol Nephrol 42:915–920PubMedCrossRefGoogle Scholar
  19. 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
  20. 20.
    Kuuva N, Nilsson CG (2002) A nationwide analysis of complications associated with the tension-free vaginal tape (TVT) procedure. Acta Obstet Gynecol Scand 81:72PubMedCrossRefGoogle Scholar
  21. 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. 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
  23. 23.
    Hammad FT, Kennedy-Smithe A, Robinson RG (2005) Erosions and urinary retention following polypropylene synthetic sling: Australasian survey. Eur Urol 47:641–646PubMedCrossRefGoogle Scholar
  24. 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
  25. 25.
    Rahul M, Sudhir A, Saroj S, Sanjay C, Kusum H (2009) Urinary tract infections caused by Pseudomonas aeruginosa: a minireview. J Inf Pub Health 2(3):101–111CrossRefGoogle Scholar
  26. 26.
    Velemir L, Amblard J, Jacquetin B, Fatton B (2008) Urethral erosion after suburethral synthetic slings: risk factors, diagnosis and functional outcome after surgical management. IntUrogynecol J Pelvic Floor Dysfunct 19:999–1006CrossRefGoogle Scholar
  27. 27.
    Reich A, Wiesner K, Kohorst F, Kreienberg R, Flock F (2009) Comparison of transobturator vaginal tape and retropubic tension-free vaginal tape: clinical outcome and sonographic results of a case–control study. Gynecol Obstet Invest 68(2):137–144PubMedCrossRefGoogle Scholar
  28. 28.
    Holmgren C, Nilsson S, Lanner L, Hellberg D (2007) Frequency of de novo urgency in 463 women who had undergone the tension-free vaginal tape (TVT) procedure for genuine stress urinary incontinence—a long-term follow-up. Eur J Obst Gyn Rep Biol 132(1):121–125CrossRefGoogle Scholar
  29. 29.
    Davis C, Cohen M, Gruber M, Anderson M, Warren M (1984) Urothelial hyperplasia and neoplasia: a response to chronic urinary tract infections in rats. J Urol 132(5):1025–1031PubMedGoogle Scholar
  30. 30.
    Giri Sk, Drumm J, Flood HD (2005) Endoscopic holmium laser excision of intravesical tension-free vaginal tape and polypropylene suture after anticontinence procedures. J Urol 174(4Pt 1):1306–1307PubMedCrossRefGoogle Scholar
  31. 31.
    Frenkl TL, Rackley RR, Vasavada SP, Goldman HB (2008) Management of iatrogenic foreign bodies of the bladder and urethra following pelvic floor surgery. Neurourol Urodyn 27:491–495PubMedCrossRefGoogle Scholar
  32. 32.
    Feiner B, Auslander R, Mecz Y, Lissak A, Stein A, Abramov Y (2009) Removal of an eroded transobturator tape from the bladder using laser cystolithotripsy and cystoscopic resection. Urology 73(681):e15–e16PubMedGoogle Scholar

Copyright information

© The International Urogynecological Association 2011

Authors and Affiliations

  • Vasileios I. Sakalis
    • 1
    Email author
  • Anastasia Chr. Gkotsi
    • 2
  • Argyrios Triantafyllidis
    • 1
  • Apostolos Giouris
    • 3
  • Stavros Charalambous
    • 1
  1. 1.Department of UrologyHippokrateion General Hospital of ThesalonikiThessalonikiGreece
  2. 2.Department of Experimental PhysiologyAristotle University of ThessalonikiThessalonikiGreece
  3. 3.Department of UrologyGeneral Hospital of SerresSerresGreece

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