The retropubic tension-free vaginal tape (TVT) procedure is a common procedure with complications attributed to voiding dysfunction, bladder perforation, and bleeding. We present a case of successful removal of a retropubic midurethral sling from the urethra using a head lamp and a combination of ear, nose, and throat instruments.
A 63-year-old woman presented to our clinic with the symptom of gross hematuria after having undergone a TVT procedure. On office cystoscopy, the sling was noted to be placed within the urethral mucosa. Removal of the mesh was performed using a nasal speculum, left and right ethmoid scissors, left and right Blakesley graspers, and a head lamp to dissect the mesh directly out of the urethra.
The utilization of ear, nose, and throat tools allowed us to resect the intraurethral mesh without necessitating incision of the urethral sphincter.
Excision of a misplaced tension-free vaginal tape was attempted by using a head lamp, nasal speculum, and other ear, nose, and throat instruments.
Center for Urogynecology and Pelvic Reconstructive Surgery, Obstetrics, Gynecology & Women's Health Institute, Cleveland Clinic, Cleveland, Ohio.
Corresponding author: Ellen R. Solomon, MD, Department of Obstetrics and Gynecology, Division of Urogynecology and Pelvic Surgery, Baystate Medical Center Springfield, MA 01199; e-mail: firstname.lastname@example.org.
Presented at the 34rd Annual Scientific American Urogynecologic Society Meeting, October 16–19, 2013, Las Vegas, Nevada.
Financial Disclosure The authors did not report any potential conflicts of interest.