Lo Tsia-Shu, Lee Shu-Jane
Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taoyuan, Taiwan.
J Obstet Gynaecol Res. 2007 Oct;33(5):739-42. doi: 10.1111/j.1447-0756.2007.00643.x.
The tension-free vaginal tape (TVT) procedure is a simple, effective and minimally invasive method for the surgical treatment of urodynamic stress incontinence (USI). Yet, complications such as mesh protrusion and recurrent urinary leakages after TVT have been reported. A case of recurrent USI complicated with vaginal mesh protrusion following a TVT procedure was referred. Video-urodynamics and introital ultrasonography confirmed that the recurrence of USI was secondary to mal-position of the protruded TVT. A simple salvaging procedure was carried out. The mal-positioned distal protruded TVT was resected and a second intermediate piece of polypropylene (Prolene) mesh was replaced at mid-urethra. The operation time was short and blood loss was minimal. The patient was objectively continent at 6 months follow-up with no defect of healing. Considering the cost-effectiveness and invasiveness of the surgeries, the method of inserting an intermediate mesh is clinically useful.
无张力阴道吊带术（TVT）是一种用于手术治疗尿动力学压力性尿失禁（USI）的简单、有效且微创的方法。然而，已有报道称TVT术后出现诸如网片突出和复发性尿漏等并发症。本文报告了1例TVT术后复发性USI合并阴道网片突出的病例。视频尿动力学检查和阴道超声检查证实，USI复发是由于突出的TVT位置不当所致。实施了一种简单的补救手术。切除位置不当的远端突出TVT，并在尿道中段更换第二块中间聚丙烯（普理灵）网片。手术时间短，出血量少。随访6个月时患者客观上已无尿失禁，且愈合无缺陷。考虑到手术的成本效益和侵入性，插入中间网片的方法在临床上是有用的。
