Delayed mesh exposure after tension-free vaginal tape (TVT) procedure is rare. We report a case of mesh exposure into the vagina and urethra that developed 10 years after TVT surgery. A 58-year-old postmenopausal woman presented with mixed urinary incontinence. She was investigated, and her stress urinary incontinence was cured with a TVT procedure 10 years ago. She was then scheduled follow-up annually. Two years postsurgery, a granulation tissue was observed and excised at the vaginal incision site. Vaginal examination 10 years postsurgery showed vaginal mesh erosion 0.5 cm from urethral meatus. Cystoscopy revealed concomitant urethral erosion at the posterior urethral wall. Mesh excision was performed, and urethra and vagina were repaired in layers. Postoperative recovery was uneventful. This finding shows that, although rare, complications can occur even after 10 years of TVT surgery.
Late complication Vagina Urethra Mesh exposure TVT
Conflicts of interest
Clemens JQ, DeLancey JO, Faerber GJ, Westney OL, McGuire EJ (2000) Urinary tract erosions after synthetic pubovaginal slings: diagnosis and management strategy. Urology 56(4):589–594PubMedCrossRefGoogle Scholar
Olsson I, Abrahamsson AK, Kroon UB (2010) Long-term efficacy of the tension-free vaginal tape procedure for the treatment of urinary incontinence: a retrospective follow-up 11.5 years post-operatively. Int Urogynecol J 21(6):679–683. doi:10.1007/s00192-009-1083-7PubMedCrossRefGoogle Scholar
Lo TS (2004) Tension-free vaginal tape procedures in women with stress urinary incontinence with and without co-existing genital prolapse. Curr Opin Obstet Gynecol 16(5):399–404PubMedCrossRefGoogle Scholar
Chen HY, Ho M, Hung YC, Huang LC (2008) Analysis of risk factors associated with vaginal erosion after synthetic sling procedures for stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 19(1):117–121. doi:10.1007/s00192-007-0400-2PubMedGoogle Scholar