International Urogynecology Journal

, Volume 24, Issue 3, pp 519–521 | Cite as

Delayed vaginal and urethral mesh exposure: 10 years after TVT surgery

  • Siwatchaya Khanuengkitkong
  • Tsia-Shu Lo
  • Anil Krishna Dass
Case Report

Abstract

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.

Keywords

Late complication Vagina Urethra Mesh exposure TVT 

Notes

Conflicts of interest

None.

References

  1. 1.
    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
  2. 2.
    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/s00192-009-1083-7 PubMedCrossRefGoogle Scholar
  3. 3.
    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
  4. 4.
    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/s00192-007-0400-2 PubMedGoogle Scholar
  5. 5.
    Wadie BS (2009) Endoscopic excision of an eroding calcified mesh sling, 10 years after primary surgery. Int Urogynecol J Pelvic Floor Dysfunct 20(2):255–257. doi: 10.1007/s00192-008-0698-4 PubMedCrossRefGoogle Scholar

Copyright information

© The International Urogynecological Association 2012

Authors and Affiliations

  • Siwatchaya Khanuengkitkong
    • 1
    • 2
  • Tsia-Shu Lo
    • 3
    • 5
  • Anil Krishna Dass
    • 1
    • 4
  1. 1.Fellow of the Division of Urogynaecology, Department of Obstetrics & Gynaecology, Chang Gung Memorial HospitalChang Gung University, School of MedicineTaoyuanRepublic of China
  2. 2.Department of Obstetrics & Gynaecology, Faculty of MedicinePrince of Songkla UniversityHatyaiThailand
  3. 3.Division of Urogynaecology, Department of Obstetrics & Gynaecology, Chang Gung Memorial HospitalChang Gung University, School of MedicineTaoyuanRepublic of China
  4. 4.Urogynaecology Unit, Department of Obstetrics & GynaecologyPenang HospitalPenangMalaysia
  5. 5.Division of Urogynecology, Department of Obstetrics and GynecologyChang Gung Memorial Hospital, Linkou Medical CenterTao-Yuan HsienRepublic of China

Personalised recommendations