Laparoscopic TVT Sling Removal Following Prior Transvaginal Sling Excision

Sagarika Sinha, DO, John R. Miklos, MD, Robert D. Moore, DO

Atlanta Urogynecology Associates, Alpharetta, GA, USA (all authors).

ABSTRACT

Several studies have reported the incidence and prevalence of retropubic tension-free vaginal mesh tape (TVT) slingrelated complications, but there are no specific current guidelines regarding the surgical management of such complications. Complications requiring sling removal, such as pain, can be surgically managed by using either a vaginal approach, removing the vaginal portion of the sling up to the pubocervical fascia, and/or a laparoscopic/abdominal approach to the space of Retzius to remove the retropubic portion of the sling. We report a case of a patient with a retropubic TVT sling in whom the removal of the vaginal portion of the sling failed to resolve the patient’s symptoms of pain; therefore, a laparoscopic approach to the retropubic space was performed to extract the remaining limbs of the sling.

Key Words: TVT sling, Mesh complication, vaginal mesh, Laparoscopic, Stress Urinary Incontinence.

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