Abstract
Background
A rare but challenging complication of midurethral tape procedures is perforation of the tape through the bladder wall.
Cases
We saw three patients in whom unrecognized bladder perforation during TVT-Secur™ procedures occurred. It took an average follow-up time of 11 months before the bladder perforations were identified by introital ultrasound. Complete excision of the mesh was achieved endoscopically (TURP resectoscope) and/or by traditional vaginal tape removal techniques. Following tape removal, there has been no recurrence of urinary tract infections, and the irritative voiding symptoms have resolved in all three cases.
Conclusions
Bladder perforation after mini-sling procedures can be managed using a combined transurethral/vaginal approach. This technique is minimally invasive, safe, and successful. Careful introital ultrasound should be performed in patients presenting with new lower urinary tract symptoms after sling surgery to avoid delays in diagnosing bladder perforation.
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References
Viereck V, Eberhard J (2008) Surgical Treatment of Urinary Incontinence – Indications, Choice of the Surgical Approach, Surgical Technique, Treatment of Complications. J Urol Urogynäkol 15:37–42
Nilsson CG, Palva K, Aarnio R, Morcos E, Falconer C (2013) Seventeen years’ follow-up of the tension-free vaginal tape procedure for female stress urinary incontinence. Int Urogynecol J. doi:10.1007/s00192-013-2090-2
Abouassaly R, Steinberg JR, Lemieux M, Marois C, Gilchrist LI, Bourque JL, le Tu M, Corcos J (2004) Complications of tension-free vaginal tape surgery: a multi-institutional review. BJU Int 94:110–113
Kuuva N, Nilsson CG (2002) A nationwide analysis of complications associated with the tension-free vaginal tape (TVT) procedure. Acta Obstet Gynecol Scand 81:72–77
Latthe PM, Foon R, Toozs-Hobson P (2007) Transobturator and retropubic tape procedures in stress urinary incontinence: a systematic review and meta-analysis of effectiveness and complications. BJOG 114:522–531
Richter HE, Albo ME, Zyczynski HM, Kenton K, Norton PA, Sirls LT, Kraus SR, Chai TC, Lemack GE, Dandreo KJ, Varner RE, Menefee S, Ghetti C, Brubaker L, Nygaard I, Khandwala S, Rozanski TA, Johnson H, Schaffer J, Stoddard AM, Holley RL, Nager CW, Moalli P, Mueller E, Arisco AM, Corton M, Tennstedt S, Chang TD, Gormley EA, Litman HJ, Urinary Incontinence Treatment Network (2010) Retropubic versus transobturator midurethral slings for stress incontinence. N Engl J Med 362:2066–2076
Kociszewski J, Viereck V (2013) Introital ultrasound in the diagnosis of occult abscesses following a tape procedure: a case report. Arch Gynecol Obstet. doi:10.1007/s00404-013-2792-1
Neuman M (2008) Perioperative complications and early follow-up with 100 TVT-SECUR procedures. J Minim Invasive Gynecol 15:480–484
Hubka P, Masata J, Nanka O, Grim M, Martan A, Zvarova J (2009) Anatomical relationship and fixation of tension-free vaginal tape Secur. Int Urogynecol J 20:681–688
Viereck V, Rautenberg O, Kociszewski J, Grothey S, Welter J, Eberhard J (2013) Midurethral sling incision: indications and outcomes. Int Urogynecol J 24:645–653
Bianchi-Ferraro AM, Jarmy-Di Bella ZI, Castro RD, Bortolini MA, Sartori MG, Girao MJ (2012) Single-incision sling compared with transobturator sling for treating stress urinary incontinence: a randomized controlled trial. Int Urogynecol J. doi:10.1007/s00192-012-1998-2
Cornu JN, Sebe P, Peyrat L, Ciofu C, Cussenot O, Haab F (2010) Midterm prospective evaluation of TVT-Secur reveals high failure rate. Eur Urol 58:157–161
Barber MD, Weidner AC, Sokol AI, Amundsen CL, Jelovsek JE, Karram MM, Ellerkmann M, Rardin CR, Iglesia CB, Toglia M, Foundation for Female Health Awareness Research Network (2012) Single-incision mini-sling compared with tension-free vaginal tape for the treatment of stress urinary incontinence: a randomized controlled trial. Obstet Gynecol 119:328–337
Masata J, Svabik K, Zvara K, Drahoradova P, El Haddad R, Hubka P, Martan A (2012) Randomized trial of a comparison of the efficacy of TVT-O and single-incision tape TVT SECUR systems in the treatment of stress urinary incontinent women—2-year follow-up. Int Urogynecol J 23:1403–1412
Walsh CA (2011) TVT-Secur mini-sling for stress urinary incontinence: a review of outcomes at 12 months. BJU Int 108:652–657
Andrada Hamer M, Larsson PG, Teleman P, Bergqvist CE, Persson J (2013) One-year results of a prospective randomized, evaluator-blinded, multicenter study comparing TVT and TVT Secur. Int Urogynecol J 24:223–229
Foley C, Patki P, Boustead G (2010) Unrecognized bladder perforation with mid-urethral slings. BJU Int 106:1514–1518
Kociszewski J, Rautenberg O, Kolben S, Eberhard J, Hilgers R, Viereck V (2010) Tape functionality: position, change in shape, and outcome after TVT procedure—mid-term results. Int Urogynecol J 21:795–800
Kociszewski J, Rautenberg O, Perucchini D, Eberhard J, Geissbuhler V, Hilgers R, Viereck V (2008) Tape functionality: sonographic tape characteristics and outcome after TVT incontinence surgery. Neurourol Urodyn 27:485–490
Bekker MD, Bevers RF, Elzevier HW (2010) Transurethral and suprapubic mesh resection after Prolift bladder perforation: a case report. Int Urogynecol J 21:1301–1303
Quiroz LH, Cundiff GW (2009) Transurethral resection of tension-free vaginal tape under tactile traction. Int Urogynecol J 20:873–875
Sakalis VI, Gkotsi AC, Triantafyllidis A, Giouris A, Charalambous S (2012) Transurethral holmium laser intravesical tape excision following TVT procedure: results from seven patients in a 12-month follow-up. Int Urogynecol J 23:769–777
Shrotri KN, Shervington JP, Shrotri NC (2010) Laser excision of encrusted intra-vesical tension-free vaginal tape (TVT). Int Urogynecol J 21:375–377
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Zivanovic, I., Kociszewski, J., Eberhard, J. et al. Bladder perforation after TVT-Secur™ procedure: how secure is TVT-Secur™?. Arch Gynecol Obstet 289, 131–134 (2014). https://doi.org/10.1007/s00404-013-2968-8
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DOI: https://doi.org/10.1007/s00404-013-2968-8