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Missed Diagnosis of Complete Urethral Transection After Sling: The Case for Translabial Ultrasound

Rogo-Gupta, Lisa MD*; Le, Ngoc-Bich MD*; Raz, Shlomo MD

Female Pelvic Medicine & Reconstructive Surgery: January/February 2012 - Volume 18 - Issue 1 - p 60–62
doi: 10.1097/SPV.0b013e31823bc342
Case Reports

Abstract: Patients with complications of urethral sling placement for stress urinary incontinence are often treated for recurrent symptoms for years after initial reassuring evaluation. Translabial ultrasound is a noninvasive modality with minimal risks that can clearly diagnose urethral mesh complications. We present a 47-year-old premenopausal woman referred for treatment of urethral stricture and diverticulum 8 years after mesh sling placement. The diagnosis was made at an outside institution by voiding cystourethrogram and cystoscopy. However, translabial ultrasound confirmed the diagnosis of complete urethral transection, and the patient underwent a complex urethral reconstruction. Ultrasound should be used to evaluate patients with a history of urethral sling and persistent lower urinary tract symptoms. Referral to a center with advanced pelvic reconstruction services may be required.

Translabial ultrasound is a noninvasive diagnostic test with minimal risks that can clearly diagnose urethral mesh complications in women with recurrent symptoms.

From the *Division of Pelvic Medicine and Reconstructive Surgery, and †Division of Pelvic Medicine and Reconstructive Surgery, Department of Urology, University of California Los Angeles, Los Angeles, CA.

Reprints: Lisa Rogo-Gupta, MD, Division of Pelvic Medicine and Reconstructive Surgery, Department of Urology, Suite #140, 200 Medical Plaza, Los Angeles, CA, 90095. E-mail: lrogogupta@mednet.ucla.edu.

The authors declare that they have nothing to disclose.

© 2012 by Wolters Kluwer Health | Lippincott Williams & Wilkins