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Bladder perforation after TVT-Secur procedure: how secure is TVT-Secur?
Irena Zivanovic1, Jacek Kociszewski, Jakob Eberhard
1Department of Gynecology and Obstetrics, Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland.
Archives of Gynecology and Obstetrics
|July 23, 2013
Summary
Unrecognized bladder perforation after midurethral tape procedures, like TVT-Secur, can be diagnosed with introital ultrasound. A combined endoscopic and vaginal approach successfully removed the mesh, resolving symptoms and infections.
Area of Science:
- Urology
- Gynecologic Surgery
Background:
- Midurethral tape procedures are common for stress urinary incontinence.
- Bladder perforation is a rare but serious complication of these procedures.
Observation:
- Three cases of unrecognized bladder perforation following TVT-Secur procedures are presented.
- Diagnosis was delayed, averaging 11 months, identified via introital ultrasound.
- Symptoms included urinary tract infections and irritative voiding issues.
Findings:
- Complete mesh excision was achieved using a combined transurethral (TURP resectoscope) and vaginal approach.
- Post-excision, patients experienced resolution of urinary tract infections and irritative voiding symptoms.
- The minimally invasive approach proved safe and successful.
Implications:
- Early diagnosis of bladder perforation is crucial for optimal patient outcomes.
- Introital ultrasound is recommended for patients with new lower urinary tract symptoms post-sling surgery.
- A combined transurethral/vaginal approach offers an effective management strategy for tape-induced bladder perforation.
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