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Int Urogynecol J Pelvic Floor Dysfunct. 2007 Feb;18(2):223-5. Epub 2006 Apr 21.

Vaginal revision of intravesical tension-free vaginal tape 44 h after initial placement: a case report.

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  • 1Department of Obstetrics and Gynecology, Division of Urogynecology and Reconstructive Pelvic Surgery, UMass Memorial Medical Center, 119 Belmont Street, Worcester, MA 01605, USA. labinl@ummhc.org

Abstract

Unintentional cystotomy is a known complication of the tension-free vaginal tape procedure and is commonly diagnosed intraoperatively. Delayed diagnosis does occur and various reparative techniques have been described, some requiring laparotomy with intentional cystotomy and repair. We report a case where a 46-year-old woman underwent vaginal reconstructive surgery including placement of a tension-free vaginal tape, which was complicated by unilateral cystotomy. A delayed diagnosis of intravesical tape placement was made requiring reoperation. The patient underwent a minimally invasive transvaginal procedure for removal and immediate replacement of the malpositioned arm of the tape. We conclude that a transvaginal approach may be an acceptable technique for revision and replacement of the tension-free vaginal tape where cystotomy is identified within 44 h after the initial procedure. With this technique, a more invasive surgery including laparotomy with cystotomy might successfully be avoided.

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