Tsivian Alexander, Kessler Oded, Mogutin Baruch, Rosenthal Jonathan, Korczak Doron, Levin Samuel, Sidi A Ami
Department of Urologic Survey, Edith Wolson Medical Center and Sackler Faculty of Medicine-Tel Aviv University, Holon, Israel.
J Urol. 2004 Feb;171(2 Pt 1):762-4. doi: 10.1097/01.ju.0000106083.51860.ca.
The tension-free vaginal tape (TVT) procedure is a recent modality for managing female stress urinary incontinence. While this procedure is rapidly gaining popularity worldwide, little has been written about its complications. We describe our experience with diagnosing and treating tape related complications following the TVT procedure.
During the last 4 years 12 patients underwent and 1 is scheduled for additional surgery for complications resulting from the TVT. Another patient is only being observed. Their records were reviewed to retrieve data on presenting symptoms and signs, diagnostic tests, surgical procedures and outcomes.
One patient had tape erosion into the bladder, 5 had vaginal tape erosion (concomitant urethral obstruction in 1) and another 8 had an obstructed urethra. The more common presenting symptoms were persistent urethral pain, recurrent urinary tract infection, urgency, urge incontinence and vaginal discharge. A total of 12 patients required partial tape removal or tape incision, which was done transvaginally in 11. The remaining patient underwent cystotomy and excision of the intravesical part of an eroded tape. One patient is awaiting corrective surgery and 1 with asymptomatic vaginal erosion is only being observed. No formal urethrolysis was performed in any case. Mean followup after corrective surgery in 12 patients was 4.8 months (range 1 to 30), during which 10 remained continent and all 12 were symptom-free.
Urologists should be aware of the nature and symptoms of tape related complications associated with a TVT procedure for prompt diagnosis and appropriate postoperative management.
无张力阴道吊带术（TVT）是治疗女性压力性尿失禁的一种新方法。尽管该手术在全球范围内迅速普及，但关于其并发症的报道却很少。我们描述了我们在诊断和治疗TVT手术后与吊带相关并发症方面的经验。
在过去4年中，12例患者因TVT手术并发症接受了手术，1例计划进行额外手术。另1例患者仅接受观察。回顾他们的病历以获取有关症状体征、诊断检查、手术过程和结果的数据。
1例患者吊带侵蚀入膀胱，5例发生阴道吊带侵蚀（其中1例伴有尿道梗阻），另外8例出现尿道梗阻。较常见的症状有持续性尿道疼痛、反复尿路感染、尿急、急迫性尿失禁和阴道分泌物。共有12例患者需要部分取出吊带或切开吊带，其中11例经阴道进行。其余1例患者接受膀胱切开术并切除侵蚀吊带的膀胱内部分。1例患者等待矫正手术，1例无症状阴道侵蚀患者仅接受观察。所有病例均未进行正规的尿道松解术。12例患者矫正手术后的平均随访时间为4.8个月（范围1至30个月），在此期间，10例患者仍保持控尿，所有12例患者均无症状。
泌尿外科医生应了解与TVT手术相关的吊带并发症的性质和症状，以便及时诊断并进行适当的术后处理。
