Background: Urinary incontinence is a common chronic health problem among women. Because physical therapists are likely to see patients postoperatively, therapists may play a role in screening for postoperative complications. The purpose of this case report was to demonstrate the importance of carefully monitoring a woman's response to physical therapy (PT) intervention post–tension-free vaginal tape-obturator sling procedure whose persistent symptoms were due to sling failure.
Study Design: This is a PT case report that examined patient outcomes and response to PT interventions to determine appropriate referral to a urogynecologist.
Case Description: A 62-year-old female patient presented with recurrence of urinary urgency, frequency, and leakage 9 months status post-tension-free vaginal tape-obturator sling surgery. The patient was seen for 8 visits over a 12-week period. Interventions included biofeedback, pelvic floor exercises and home program, instruction in “the Knack,” extracorporeal magnetic treatment, and bladder retraining.
Outcomes: Although the patient's score on the Urogenital Distress Inventory Short Form 6 improved from 62.5 to 33.3, analysis of the individual questions demonstrated mixed improvement. The patient's Pelvic Floor Impact Questionnaire–Short Form 7 urine/bladder score worsened from 61.9 to 66.7. Bladder diary outcomes were mixed. She was referred to her urogynecologist because of mixed outcomes combined with failure to achieve all long-term goals within 8 treatment sessions. Subsequent urodynamic testing revealed sling failure.
Discussion: This case report demonstrated the importance of carefully monitoring a woman's response to PT intervention post–tension-free vaginal tape-obturator sling procedure whose persistent symptoms were due to sling failure.
1Jersey Shore University Medical Center, Neptune, New Jersey, Meridian Rehab at Neptune.
2Division of Physical Therapy, Shenandoah University, Winchester, Virginia.
The authors declare no conflicts of interest.