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Case Reports
. 2019 Apr 30;13(1):119.
doi: 10.1186/s13256-019-2059-y.

Transobturator tape material detected in the bladder neck: a case report

Yavuz Güler  1 , Akif Erbin  2 , Burak Üçpınar  2
Affiliations
Case Reports

Transobturator tape material detected in the bladder neck: a case report

Yavuz Güler et al. J Med Case Rep. .

Abstract

Introduction: Stress urinary incontinence surgeries (transobturator tape and tension-free vaginal tape) are safely performed with success rates over 90%. The transobturator tape procedure attracted more attention due to the lack of major complications, such as intraabdominal organ and vascular injuries, related to the tension-free vaginal tape procedure. Although there are no major or mortality-related complications, more lower urinary complaints, especially vaginal erosion, are reported in transobturator tape surgery. Here we present a rare complication of transobturator tape surgery: the accidental placement of mesh material in the bladder neck. With this case report, we aimed to discuss the diagnosis and management of misplaced transobturator tape material.

Case presentation: A 38-year-old Caucasian woman who had stress urinary incontinence that had persisted for 6 years underwent transobturator tape surgery in a different clinic 2 years ago. Subsequently, she presented to our clinic with lower urinary tract complaints such as incontinence and dysuria. A physical examination was unremarkable besides total incontinence. A diagnostic cystoscopy was performed and sling material that crossed her bladder neck from 3 o'clock to 10 o'clock was identified. The misplaced transobturator tape material was cut endoscopically with an internal urethrotomy knife. Afterwards, a midurethral incision was made and mesh parts were removed bilaterally. After successful removal of the mesh material, a new transobturator tape was placed.

Conclusions: Even though transobturator tape surgery is a safe and effective procedure for stress urinary incontinence, certain complications can be encountered. Misplacement of the mesh material through the bladder neck is a rare complication and can be managed by successfully removing the mesh material and appropriately placing new transobturator tape material.

Keywords: Neuro-urology; Stress incontinence; Transobturator tape surgery; Uro-gynecology.

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Ethics approval and consent to participate

Not applicable.

Consent for publication

Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
The blue arrows show the mesh material passing through the bladder neck. The red arrow indicates the granulation tissue around the sling material. The dark arrow shows the urethrotomy knife
See this image and copyright information in PMC

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