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The placement of transobturator sub-urethral synthetic tapes, although with a high success rate of achieving continence, carries the risk of tape erosion to adjacent structures. While vaginal erosion occurs more frequently, urethral erosion has also been reported, usually in the immediate or early postoperative period. We present two different cases of urethral erosion with the Obtape((R)) sling, the first one diagnosed 1 year after surgery and the second one, a very late complication, occurring 4 years after the placement of the sling. Although transvaginal urethrotomy with tape resection has been the most popular approach described in the literature, we describe a minimally invasive trans-urethral approach for the management of this complication under local anaesthesia. We also present some "tricks of the trade" on retrieving the tape trans-urethrally while maximizing the length of tape removed.
Centro Hospitalar Lisboa Norte, Lisbon, Portugal, email@example.com.
This article was published in the following journal.
Name: International urogynecology journal and pelvic floor dysfunction
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Liposomal bupivacaine or placebo will be administered at the end of a transobturator midurethral sling to determine if there is a difference in a patient's perceived postoperative pain.
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Any woven or knit material of open texture used in surgery for the repair, reconstruction, or substitution of tissue. The mesh is usually a synthetic fabric made of various polymers. It is occasionally made of metal.
Cancer or tumors of the URETHRA. Benign epithelial tumors of the urethra usually consist of squamous and transitional cells. Primary urethral carcinomas are rare and typically of squamous cells. Urethral carcinoma is the only urological malignancy that is more common in females than in males.
A birth defect due to malformation of the URETHRA in which the urethral opening is below its normal location. In the male, the malformed urethra generally opens on the ventral surface of the PENIS or on the PERINEUM. In the female, the malformed urethral opening is in the VAGINA.
Procedures that avoid use of open invasive surgery in favor of closed or local surgery. These generally involve use of laparoscopic devices and remote-control manipulation of instruments with indirect observation of the surgical field through an endoscope or similar device. With the reduced trauma associated with minimally invasive surgery, long hospital stays may be reduced with increased rates of short stay or day surgery.
A birth defect due to malformation of the URETHRA in which the urethral opening is above its normal location. In the male, the malformed urethra generally opens on the top or the side of the PENIS, but the urethra can also be open the entire length of the penis. In the female, the malformed urethral opening is often between the CLITORIS and the labia, or in the ABDOMEN.