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.
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.
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.
Visualization of the sling material with ultrasound guidance was performed to ensure proper localization and resection.
From the Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, OK.
Reprints: S. Abbas Shobeiri, MD, FACOG, Section of Female Pelvic Medicine & Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, 920 Stanton L. Young Blvd, (PO Box 26901), WP2410, Oklahoma City, OK 73190. E-mail: Abbas-Shobeiri@ouhsc.edu.
M.S. Mukati contributed in the project development and manuscript writing, and S.A. Shobeiri, in manuscript writing.
The authors have declared they have no conflicts of interest.