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Martius Graft for the Management of Tension-Free Vaginal Tape Vaginal Erosion

Al-Wadi, Khalid MBBS; Al-Badr, Ahmed MBBS, FRCS(C), FACOG

doi: 10.1097/AOG.0b013e31819eca9b
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BACKGROUND: The tension-free vaginal tape (TVT) procedure has become standard for the treatment of stress urinary incontinence in women. The procedure carries a risk of vaginal erosion and exposure of the mesh. When this occurs, most surgeons recommend removal of the tape for immediate relief of symptoms. However, this poses a risk of recurrence of urinary incontinence.

CASE: A premenopausal woman had an exposed vaginal mesh after a TVT procedure. After failed conservative treatment, she was treated successfully using a Martius graft, with preservation of the mesh.

CONCLUSION: The Martius procedure was a practical alternative for treating this patient with synthetic-mesh–induced vaginal erosion. It allowed preservation of the sling, thereby preventing recurrence of urinary incontinence.

Using a Martius graft is a practical alternative for treating tension-free vaginal tape vaginal erosion, allowing preservation of the sling and avoiding urinary incontinence recurrence.

From the Division of Urogynecology and Pelvic Reconstructive Surgery, Women’s Specialized Hospital, King Fahad Medical City, Riyadh, Saudi Arabia.

Corresponding author: Khalid Al-Wadi, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, 1711-55 Garry Street, Winnipeg, Manitoba, R3C 4H4, Canada; e-mail: alwadikhaled@hotmail.com.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2009 by The American College of Obstetricians and Gynecologists.