Labin Lisa C, Morse Abraham N, Young Stephen B
Department of Obstetrics and Gynecology, Division of Urogynecology and Reconstructive Pelvic Surgery, UMass Memorial Medical Center, 119 Belmont Street, Worcester, MA 01605, USA.
Int Urogynecol J Pelvic Floor Dysfunct. 2007 Feb;18(2):223-5. doi: 10.1007/s00192-006-0122-x. Epub 2006 Apr 21.
Unintentional cystotomy is a known complication of the tension-free vaginal tape procedure and is commonly diagnosed intraoperatively. Delayed diagnosis does occur and various reparative techniques have been described, some requiring laparotomy with intentional cystotomy and repair. We report a case where a 46-year-old woman underwent vaginal reconstructive surgery including placement of a tension-free vaginal tape, which was complicated by unilateral cystotomy. A delayed diagnosis of intravesical tape placement was made requiring reoperation. The patient underwent a minimally invasive transvaginal procedure for removal and immediate replacement of the malpositioned arm of the tape. We conclude that a transvaginal approach may be an acceptable technique for revision and replacement of the tension-free vaginal tape where cystotomy is identified within 44 h after the initial procedure. With this technique, a more invasive surgery including laparotomy with cystotomy might successfully be avoided.
非故意膀胱切开术是无张力阴道吊带手术已知的一种并发症，通常在术中被诊断出来。延迟诊断确实会发生，并且已经描述了各种修复技术，其中一些需要通过剖腹手术进行故意膀胱切开术和修复。我们报告了一例46岁女性接受阴道重建手术，包括放置无张力阴道吊带，该手术并发单侧膀胱切开术。对膀胱内吊带放置进行了延迟诊断，需要再次手术。患者接受了微创经阴道手术，以取出并立即更换吊带位置不当的臂。我们得出结论，对于在初次手术后44小时内发现膀胱切开术的情况，经阴道途径可能是一种可接受的用于修复和更换无张力阴道吊带的技术。采用这种技术，可以成功避免包括剖腹膀胱切开术在内的更具侵入性的手术。
