According to our experience the incidence of local recurrence and the risk of port site metastases is low and seems to be mainly related to the aggressiveness of the tumor and immunosuppression status of the patient, respectively rather than to technical aspects of the laparoscopic approach.

Port site metastases is a multifactorial phenomenon with an as yet undetermined incidence. The problem is influenced to some extent by surgeon and operating team experience and, therefore, it could be partially prevented. The suggested preventive steps are avoiding laparoscopic surgery when there are ascites, trocar fixation to prevent dislodgment, avoiding gas leakage along and around the trocar, sufficient technical readiness of the operating team (adequate laparoscopic equipment and technique, minimal handling and avoiding tumor boundary violation of the tumor), using a bag for specimen removal, placing drainage when needed before desufflation, povidone-iodine irrigation of instruments, trocars and port site wounds, and suturing 10 mm. and larger trocar wounds.

Urologists should be aware of the nature and symptoms of tape related complications associated with a TVT procedure for prompt diagnosis and appropriate postoperative management.

Dorsal graft urethroplasty is feasible and effective for the correction of persistent female urethral stricture.

No abstract

TVT is a safe and effective procedure for female stress urinary incontinence with an enduring, high success rate. There is a significant rate of intraoperative complications, which do not cause further problems when identified and treated during surgery. One must be alert to the significant rate of postoperative complications that usually require repeat surgery, which is relatively simple and causes practically no long-term morbidity. It also does not influence the continence rate in most cases.

Tension-free transvaginal tape (TVT) placement has recently become the preferred therapeutic approach for female stress urinary incontinence (SUI) in some centers. There are, however, no clearcut guidelines of how to treat patients in whom the procedure has failed. We describe our experience with repeat midurethral synthetic sling (MUS) implantation after a failed similar procedure. Twelve women (mean age 64.3 years) who had undergone a MUS procedure [TVT-9, intravaginal sling (IVS)-2, transobturator tape (TOT)-1] for SUI underwent a repeat MUS (TVT-5, IVS-4, TOT-3) due to persistent or recurrent SUI. The time from the first to the second procedure was 1-48 months. Eleven out of 12 patients (91.7%) achieved full continence (mean follow-up of 23.2 months, range 14-44). We conclude that a repeat MUS for persistent or recurrent SUI is a viable option for patients after an unsuccessful MUS procedure.

Combining laparoscopic renal surgery and laparoscopic cholecystectomy is a feasible, efficacious, and safe strategy that requires close collaboration between urologists and general surgeons. This approach offers the patient the benefits of minimally invasive surgery together with the obvious advantages of simultaneous treatment of coexisting pathologies.