Abstract
Persistent pain after a tension-free vaginal tape procedure is rare. Perforation or erosion of the tape into the bladder, urethra, or vagina; hematoma formation; and tape rejection are the most common causes. Less frequent causes are injury to the pelvic bone or to iliopectineal ligaments. In this case report, we present the passage of the tape through a nerve structure as the source of persistent and severe retropubic pain. Diagnostic procedures, such as cystoscopy, ultrasound, and MRI scanning, showed no abnormal findings. Treatment was initially conservative, but only locally injected analgesics and corticosteroids relieved the pain temporarily. Finally, surgical exploration revealed the inadvertent course of the tape through branches of the ilioinguinal/iliohypogastric nerve, which only became clear after pathological examination of the excised tape.
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References
Ulmsten U, Petros P (1995) Intravaginal slingplasty (IVS): an ambulatory surgical procedure for treatment of female urinary incontinence. Scand J Urol Nephrol 29:75–82
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 7:81–85
Ward K, Hilton P (2002) Prospective multicentre randomised trial of tension-free vaginal tape and colposuspension as primary treatment for stress incontinence. BMJ 325:67
Ward KL, Hilton P (2004) A prospective multicenter randomized trial of tension-free vaginal tape and colposuspension for primary urodynamic stress incontinence: two-year follow-up. Am J Obstet Gynecol 190:324–331
Schraffordt Koops SE, Bisseling TM, Heintz AP, Vervest HA (2005) Prospective analysis of complications of tension-free vaginal tape from The Netherlands Tension-Free Vaginal Tape study. Am J Obstet Gynecol 193:45–52
Barrington JW, Arunkalaivanan AS, Swart M (2002) Post-colposuspension syndrome following a tension-free vaginal tape procedure. Int Urogynecol J Pelvic Floor Dysfunct 13:187–188
But I, Bratus D, Faganelj M (2005) Prolene tape in the bladder wall after TVT procedure—intramural tape placement or secondary tape migration? Int Urogynecol J Pelvic Floor Dysfunct 16:75–76
Duckett JR, Jain S (2005) Groin pain after a tension-free vaginal tape or similar suburethral sling: management strategies. BJU Int 95:95–97
Tunn R, Gauruder-Burmester A, Kolle D (2004) Ultrasound diagnosis of intra-urethral tension-free vaginal tape (TVT) position as a cause of postoperative voiding dysfunction and retropubic pain. Ultrasound Obstet Gynecol 23:298–301
Irvin W, Andersen W, Taylor P, Rice L (2004) Minimizing the risk of neurologic injury in gynecologic surgery. Obstet Gynecol 103:374–382
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Vervest, H.A.M., Bongers, M.Y. & van der Wurff, A.A.M. Nerve injury: an exceptional cause of pain after TVT. Int Urogynecol J 17, 665–667 (2006). https://doi.org/10.1007/s00192-005-0034-1
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DOI: https://doi.org/10.1007/s00192-005-0034-1