Wai Clifford Y, Atnip Shanna D, Williams Kristin N, Schaffer Joseph I
Division of Urogynecology/Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX 75390-9032, USA.
Int Urogynecol J Pelvic Floor Dysfunct. 2004 Sep-Oct;15(5):353-5. doi: 10.1007/s00192-004-1158-4. Epub 2004 May 14.
The suburethral sling with tension-free vaginal tape (TVT) has become a popular treatment for stress urinary incontinence. Erosion of the mesh into the urethra is rare, usually presenting with hematuria, pain, voiding dysfunction or urge incontinence. A patient with stress incontinence was treated with a TVT suburethral sling. One month later, symptoms of recurrent stress incontinence developed. Cystourethroscopy revealed urethral mesh erosion. Surgical removal involved cystourethroscopic-assisted transurethral resection of the mesh, followed by vaginal dissection and periurethral withdrawal. Urethral mesh erosion should be considered in a patient who presents with atypical symptoms after being treated with a suburethral sling. It is important to obtain a detailed history and have a high clinical index of suspicion for erosion. Careful and comprehensive urethroscopy, in addition to cystoscopy, should be a mandatory part of the TVT procedure. Further study is needed to determine the optimal technique for mesh removal.
经阴道无张力尿道中段吊带术（TVT）已成为治疗压力性尿失禁的常用方法。网片侵蚀尿道的情况罕见，通常表现为血尿、疼痛、排尿功能障碍或急迫性尿失禁。一名压力性尿失禁患者接受了TVT尿道下吊带治疗。一个月后，再次出现压力性尿失禁症状。膀胱尿道镜检查发现尿道网片侵蚀。手术切除包括膀胱尿道镜辅助经尿道切除网片，随后进行阴道分离和尿道周围取出。对于接受尿道下吊带治疗后出现非典型症状的患者，应考虑尿道网片侵蚀。详细了解病史并对侵蚀保持高度临床怀疑指数很重要。除膀胱镜检查外，仔细全面的尿道镜检查应作为TVT手术的必要组成部分。需要进一步研究以确定取出网片的最佳技术。
