Transvaginal Tape Lysis for Urinary Obstruction After Tension-Free Vaginal Tape Placement

Croak, Andrew J.; Schulte, Valerie; Peron, Salvador E.; Klingele, Christopher J.; Gebhart, John B.; Lee, Raymond

doi:10.1097/01.ju.0000063781.01787.10

Cited by 27 publications

(21 citation statements)

References 14 publications

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“…The failures after sling transection and urethrolysis could be related to persistent bladder instability and/or uncorrected obstruction. In our experience and that of others, SUI occurs infrequently after such operations [13][14][15].…”

Section: Discussionmentioning

confidence: 85%

Disabling complications with slings for managing female stress urinary incontinence

et al. 2008

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OBJECTIVETo report an increase in the referral of patients with disabling complications after the failure of conservative therapy, their presentation, final surgical management and clinical outcome, following the use of non‐autologous slings (NAS), currently the primary surgical procedure for managing stress urinary incontinence (SUI) in women.PATIENT AND METHODSThirty‐eight patients (mean age 64 years) required surgical management for disabling complications after placing a NAS for SUI. Sling types were synthetic (25), xenografts (six) and allografts (four). Twenty (53%) patients presented with bladder outlet obstruction, 13 (34%) with sling erosion, three (8%) with worsened SUI, and two (5%) with unobstructive severe urgency and frequency.RESULTSThe sling was dissected and incised with no complication in 19 of 20 patients. One had a posterior urethral defect during sling dissection. Twelve patients (60%) acquired normal voiding and were continent. Among the 13 patients who had the sling dismantled and urethrolysis, two had recurrent or persistent SUI, two de‐novo urgency/frequency and one developed osteitis pubis. Three patients with disabling SUI received a pubovaginal sling placed proximal to the bladder neck, and had an overall improvement in their urinary control with no retention. Two unobstructed patients with urgency and frequency did not improve with anticholinergic medication and pelvic floor therapy, and are now candidates for botulinum toxin injection or neurostimulation.CONCLUSIONSThe complication rate with periurethral NAS for managing SUI in females is substantial. Patients with refractory urgency/frequency after the sling need a complete evaluation with cystoscopy and video‐urodynamics. Obstruction and erosion are the commonest problems and require surgical correction.

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Section: Discussionmentioning

confidence: 85%

Disabling complications with slings for managing female stress urinary incontinence

et al. 2008

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“…According to the integral theory proposed by Ulmsten, the procedure works by promoting the activity of the pubourethral ligaments and levator ani muscles, and increasing the support of the vaginal hammock [1]. The success rate is between 84 and 91% at 3 years [2][3][4][5]. The overcorrection can lead to bladder outlet obstruction in nearly 10% of cases [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

“…The treatment of this obstruction remains surgical. The transvaginal tape lysis is considered as a fast, simple, and efficient procedure [5,9,10]. The routine tape lysis and replacement suggested by Haylen and Lee is probably not necessary [11].…”

Section: Introductionmentioning

confidence: 99%

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Transvaginal tape lysis for urinary obstruction after suburethral tape placement. When to do an immediate replacement?

et al. 2008

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To evaluate the interest and the indications of an immediate replacement of a suburethral tape after tape lysis for urinary obstruction is the aim of the study. From 2000 until 2007, a total of 22 patients underwent suburethral tape placement for stress urinary incontinence and developed thereafter a bladder outlet obstruction. These patients had a transvaginal tape lysis under local anesthesia. An immediate replacement of the tape was carried out in those patients who developed leakage under cough provocation test. Twelve patients (group 1) underwent a tape lysis and replacement. Ten patients (group 2) underwent a simple tape lysis. The two groups were demographically comparable. The continence rate was 100% in the two groups. The success rate defined by urodynamics was 75% for the first group and 80% for the second group. The success rate defined by the disappearance of the initial symptoms and improvement of the scores of the questionnaires was 75% for the first group and 90% for the second group.

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“…Although there are no well-designed and randomized studies comparing the abdominal and vaginal routes, retrospective data indicate success rates approaching 85%, comparable for retropubic and vaginal routes. Most surgeons prefer transvaginal urethrolysis rather than retropubic or suprameatal approaches (37 (49) reported that TVT tape dissection using a midline incision for obstructive urinary retention was successful in five (6.4% of 109 TVTs) patients; four of these (80%) remained continent. The incision was performed within 4 weeks of initial placement.…”

Section: Surgical Treatmentmentioning

confidence: 99%

Evaluation and management of voiding dysfunction after midurethral sling procedures

Çelik

Harmanli

2012

J Turkish German Gynecol Assoc

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Transvaginal Tape Lysis for Urinary Obstruction After Tension-Free Vaginal Tape Placement

Abstract: Tape lysis is simple and effective for relieving obstruction, and is not associated with a high rate of recurrent stress urinary incontinence.

Cited by 27 publications

References 14 publications

Disabling complications with slings for managing female stress urinary incontinence

Disabling complications with slings for managing female stress urinary incontinence

Transvaginal tape lysis for urinary obstruction after suburethral tape placement. When to do an immediate replacement?

Evaluation and management of voiding dysfunction after midurethral sling procedures

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