Huwyler Mirjam, Springer Johannes, Kessler Thomas M, Burkhard Fiona C
Department of Urology, University of Bern, Bern, Switzerland.
BJU Int. 2008 Aug 5;102(5):582-5. doi: 10.1111/j.1464-410X.2008.07734.x. Epub 2008 May 15.
To report our experience with the successful removal of visible tension-free vaginal tape (TVT) by standard transurethral electroresection, as intravesical tape erosion after TVT is a rare complication, and removal can be challenging, with few cases reported.
Five patients presenting with TVT erosion into the bladder were treated at our institutions from December 2004 to July 2007; all had standard transurethral electroresection. Their records were reviewed retrospectively to retrieve data on presenting symptoms, diagnostic tests, surgical procedures and outcomes.
The median (range) interval between the TVT procedure and the onset of symptoms was 17 (1-32) months. The predominant symptoms were painful micturition, recurrent urinary tract infection (UTI), urgency and urge incontinence. There were no complications during surgery. The storage symptoms and UTI resolved completely after removing the eroded mesh in all but one patient. Cystoscopy at 1 month after surgery showed complete healing of the bladder mucosa.
Although TVT erosion into the bladder is rare, persistent symptoms, particularly recurrent UTIs, must raise some suspicion for this condition. Standard transurethral electroresection seems to be a safe, simple, minimally invasive and successful treatment option for TVT removal.
报告我们通过标准经尿道电切成功移除可见无张力阴道吊带（TVT）的经验，因为TVT术后膀胱内吊带侵蚀是一种罕见的并发症，移除具有挑战性，报道的病例很少。
2004年12月至2007年7月期间，我们机构对5例出现TVT侵蚀至膀胱的患者进行了治疗；均采用标准经尿道电切术。对他们的记录进行回顾性分析，以获取有关症状表现、诊断检查、手术过程及结果的数据。
TVT手术与症状出现之间的中位（范围）间隔时间为17（1 - 32）个月。主要症状为排尿疼痛、复发性尿路感染（UTI）、尿急和急迫性尿失禁。手术期间无并发症发生。除1例患者外，所有患者在移除侵蚀的网片后，储尿期症状和UTI完全缓解。术后1个月膀胱镜检查显示膀胱黏膜完全愈合。
尽管TVT侵蚀至膀胱罕见，但持续的症状，尤其是复发性UTI，必须引起对此情况的怀疑。标准经尿道电切术似乎是一种安全、简单、微创且成功的TVT移除治疗选择。
