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Successful third consecutive TVT in a patient with two previous TVT failures
Vicente Solà1, Jack Pardo, Paolo Ricci
1The Urogynecology and Vaginal Surgery Unit, Department of Obstetrics and Gynecology, Clínica Las Condes, Santiago, Chile.
Background:
During 10 years of use, the transvaginal tape (TVT) technique has proved highly effective for the treatment of stress urinary incontinence. There is limited published information about experience with repeated TVT placements.
Case:
A 47-year-old multiparous woman presented with a history of two previous TVT sling procedures but persistent urinary incontinence. Persisting urinary incontinence was noted at six months after the first placement, and a second TVT placement was also unsuccessful. The preoperative urodynamic assessment showed type II and III urinary incontinence. The uterus was enlarged to the size of a 16-week pregnancy, and a hysterectomy was performed. At the same time, a third TVT sling procedure was performed using the standard free tension sling technique, leaving the arms uncut for 24 hours. The patient has remained continent during ten months of follow-up.
Conclusion:
According to our experience with this patient, the placement of a third TVT after two failures is safe and effective.
