Introduction: Visualization of a midurethral sling may be challenging intraoperatively, especially if the sling is deep, well healed, not in the usual location, or made of materials that are not colored.
Case: We present the case of a 71-year-old woman presenting with a history of incomplete bladder emptying and debilitating voiding dysfunction documented by uroflowmetry and postvoid residual after a tension-free vaginal tape placement. Medications in addition to attempts to dilate her urethra failed to provide her with adequate relief. Intraoperative 3-dimensional ultrasound guidance was used to transect the sling that was otherwise unable to be localized with examination alone.
Conclusions: Surgical transection of a tension-free vaginal tape can be safely performed under the guidance of ultrasound. At her 12-month follow-up visit, the patient did not have urinary incontinence or voiding dysfunction.