Transurethral resection of tension-free vaginal tape penetrating the urethra

Abstract

Background: The penetration of a tension-free vaginal tape into the urethra is a rarely described complication. It might occur much more often, given the common clinical practice of tension-free vaginal tape implantation. We describe a less invasive approach to resection than the transvaginal urethral resection method previously reported in the literature.

Case: A 68-year-old woman with stress urinary incontinence underwent a tension-free vaginal tape procedure. After surgery, the woman complained about pain and voiding disorders. A urodynamic investigation performed 14 months later revealed an infravesical obstruction caused by parts of the tension-free vaginal tape penetrating the urethra. After transurethral resection of the mesh, voiding returned to normal, and the patient remained subjectively and objectively continent.

Conclusion: The transurethral approach described is a minimally invasive and successful technique that should be tried before embarking on major destructive and reconstructive surgery on the urethra.