Rapport de cas en gynécologie et obstétrique Libre accès

Abstrait

Management of a Rare Complication after Tension-free Vaginal Tape Surgery: A Case Report

Vivien Szanto* , Peter M. Fehr

Introduction: Stress urinary incontinence surgery is a common procedure currently using mostly mesh materials, that is performed around the world. Lately, the debate concerning complications and safety issues began transforming the landscape of available treatment options worldwide. In our case study, we present a rare longterm complication, diagnosis and management of transobturator tape surgery.

Case presentation: A 62-year-old caucasian woman underwent transoburator tension free vaginal tape surgery for stress urinary incontinence 3 months prior in our clinic. She presented with a recurrence of her stress urinary incontinence after initially being asymptomatic after surgery. We suspected a urethral tape erosion in the perineal ultrasound and performed a diagnostic cysto-urethroscopy, which confirmed this finding. A transvaginal resection of the tape was performed with urethroplasty of the posterior urethral wall. After a convalescence period a retropubic tension free vaginal tape surgery was performed according to the patients wishes. Follow up after 8 months showed correct tape placement and no further stress urinary incontinence.

Conclusion: Transobturator tape surgery remains an effective treatment for stress urinary incontinence with few intraoperative risks; although in rare cases severe complications can be encountered. A correct diagnosis and treatment are key in the successful management of displaced mesh material and can lead to long-term patient satisfaction.