Vaginal Mucosal Flap as a Sling Preservation for the Treatment of Vaginal Exposure of Mesh.
10.4111/kju.2010.51.6.416
- Author:
Sea Young KIM
1
;
Jong Yeon PARK
;
Han Kwon KIM
;
Chang Hoo PARK
;
Sung Jin KIM
;
Gi Teck SUNG
;
Chang Myon PARK
Author Information
1. Department of Urology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea. uropack1@gnah.co.kr
- Publication Type:Original Article
- Keywords:
Complications;
Suburethral slings;
Surgical mesh
- MeSH:
Anesthesia, Local;
Anti-Bacterial Agents;
Bandages;
Dyspareunia;
Female;
Follow-Up Studies;
Humans;
Male;
Suburethral Slings;
Surgical Mesh;
Urinary Incontinence;
Vaginal Discharge
- From:Korean Journal of Urology
2010;51(6):416-419
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Tension-free vaginal tape (TVT) procedures are used for the treatment of stress urinary incontinence in women. The procedures with synthetic materials can have a risk of vaginal erosion. We experienced transobturator suburethral sling (TOT) tape-induced vaginal erosion and report the efficacy of a vaginal mucosal covering technique. MATERIALS AND METHODS: A total of 560 female patients diagnosed with stress urinary incontinence underwent TOT procedures at our hospital between January 2005 and August 2009. All patients succeeded in follow-ups, among which 8 patients (mean age: 50.5 years) presented with vaginal exposure of the mesh. A vaginal mucosal covering technique was performed under local anesthesia after administration of antibiotics and vaginal wound dressings for 3-4 days. RESULTS: Seven of the 8 patients complained of persistent vaginal discharge postoperatively. Two of the 8 patients complained of dyspareunia of their male partners. The one remaining patient was otherwise asymptomatic, but mesh erosion was discovered at the routine follow-up visit. Six of the 8 patients showed complete mucosal covering of the mesh after the operation (mean follow-up period: 16 moths). Vaginal mucosal erosion recurred in 2 patients, and the mesh was then partially removed. One patient had recurrent stress urinary incontinence. CONCLUSIONS: Vaginal mucosal covering as a sling preservation with continued patient continence may be a feasible and effective option for the treatment of vaginal exposure of mesh after TOT tape procedures.
