Kim Sea Young, Park Jong Yeon, Kim Han Kwon, Park Chang Hoo, Kim Sung Jin, Sung Gi Teck, Park Chang Myon
Department of Urology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.
Korean J Urol. 2010 Jun;51(6):416-9. doi: 10.4111/kju.2010.51.6.416. Epub 2010 Jun 21.
Tension-free vaginal tape (TVT) procedures are used for the treatment of stress urinary incontinence in women. The procedures with synthetic materials can have a risk of vaginal erosion. We experienced transobturator suburethral sling (TOT) tape-induced vaginal erosion and report the efficacy of a vaginal mucosal covering technique.
A total of 560 female patients diagnosed with stress urinary incontinence underwent TOT procedures at our hospital between January 2005 and August 2009. All patients succeeded in follow-ups, among which 8 patients (mean age: 50.5 years) presented with vaginal exposure of the mesh. A vaginal mucosal covering technique was performed under local anesthesia after administration of antibiotics and vaginal wound dressings for 3-4 days.
Seven of the 8 patients complained of persistent vaginal discharge postoperatively. Two of the 8 patients complained of dyspareunia of their male partners. The one remaining patient was otherwise asymptomatic, but mesh erosion was discovered at the routine follow-up visit. Six of the 8 patients showed complete mucosal covering of the mesh after the operation (mean follow-up period: 16 moths). Vaginal mucosal erosion recurred in 2 patients, and the mesh was then partially removed. One patient had recurrent stress urinary incontinence.
Vaginal mucosal covering as a sling preservation with continued patient continence may be a feasible and effective option for the treatment of vaginal exposure of mesh after TOT tape procedures.
无张力阴道吊带术（TVT）用于治疗女性压力性尿失禁。使用合成材料的手术可能存在阴道侵蚀的风险。我们经历了经闭孔尿道下吊带（TOT）吊带引起的阴道侵蚀，并报告了一种阴道黏膜覆盖技术的疗效。
2005年1月至2009年8月期间，共有560例被诊断为压力性尿失禁的女性患者在我院接受了TOT手术。所有患者均成功随访，其中8例（平均年龄：50.5岁）出现网片阴道外露。在给予抗生素和阴道伤口敷料3 - 4天后，于局部麻醉下进行阴道黏膜覆盖技术。
8例患者中有7例术后抱怨持续阴道分泌物增多。8例患者中有2例抱怨其男性伴侣性交困难。其余1例患者无其他症状，但在常规随访中发现网片侵蚀。8例患者中有6例术后网片被黏膜完全覆盖（平均随访期：16个月）。2例患者阴道黏膜侵蚀复发，随后部分取出网片。1例患者复发性压力性尿失禁。
阴道黏膜覆盖作为一种保留吊带并使患者持续保持控尿的方法，对于治疗TOT吊带术后网片阴道外露可能是一种可行且有效的选择。
