Transvesical Laparoscopic Mesh Excision After Tension-Free Vaginal Tape

TL;DR

A minimally invasive laparoscopic method successfully removed an eroded vaginal tape from a woman's bladder, preserving her continence and relieving her symptoms.

Contribution

The paper presents a successful case of transvesical laparoscopic mesh excision for intravesical tape erosion.

Findings

The transvesical laparoscopic approach allowed for precise removal of the eroded tape at the bladder neck.

The patient recovered well and remained continent and symptom-free post-surgery.

This method offers excellent visualization and minimizes recurrence risks for stress urinary incontinence.

Abstract

Tension-free vaginal tape has been the gold standard for the treatment of stress urinary incontinence for over 20 years. However, rare complications like intravesical tape erosion can significantly reduce quality of life, requiring surgical removal. This procedure must preserve continence and can be challenging. We report the case of a 53-year-old woman who presented with recurrent urinary tract infections and dysuria 7 years after a TVT procedure. Imaging revealed a bladder stone attached to the eroded sling at the bladder neck, inaccessible via standard cystoscopy. A transvesical laparoscopic approach was used to successfully remove the intravesical portion of the tape. The patient recovered well and remained symptom-free and continent. Various techniques are used to perform intravesical tape resection. Transvesical laparoscopy offers excellent visualization and precise excision and minimizes recurrence risks for stress urinary incontinence. It is a safe, effective, and minimally invasive option for removing eroded tension-free vaginal tape, especially in difficult-to-access areas like the bladder neck.

Figures