Urethral diverticulum: a new complication associated with tension-free vaginal tape

A case of a urethral diverticulum following the insertion of a tension-free vaginal tape (TVT) is presented. The patient was a woman with stress urinary incontinence who underwent surgery to correct intrinsic sphincter deficiency. Three cases of urethral diverticula have been published thus far as complications of TVT insertions, but this is the first complication associated with intrinsic sphincter deficiency. The high pressures in the proximal urethra that result from positioning the TVT in the middle urethra, especially when obstruction co-exists with an open bladder neck, can be a predisposing factor for this complication. The possibility of a urethral diverticulum when postvoid incontinence occurs after the insertion of a TVT should be carefully evaluated.