Department of Urology, The First Affiliated Hospital, School of Medicine, Zhejiang University, No. 79 Qingchun Road, Hangzhou City, 310003, Zhejiang Province, People's Republic of China.
BMC Urol. 2022 Apr 22;22(1):67. doi: 10.1186/s12894-022-01016-5.
Suburethral sling with tension-free vaginal tape (TVT) has become a popular treatment for stress urinary incontinence (SUI). Erosion of the tape into the vaginal is rare. Very few patients present with vaginal tape erosion and recurrence of SUI.
A 49-year-old female patient with stress urinary incontinence was treated with a retropubic suburethral TVT sling. 2 months later, recurrent symptoms of SUI developed. 6 months later, the patient complained of repeated vaginal discharge and foreign body sensation. Body physical examination revealed a 1-cm-long tape extrusion at the left anterior vaginal wall beside the midline. Cystourethroscopy revealed no urethral mesh erosion. Surgical removal of the extrusion tape revealed that the left arm of the tape was in the vaginal mucosa layer rather than between the whole thickness of the vaginal mucosa and urethral. The tape around the urethral was dissected and removed. A new retropubic tape was placed simultaneously. At the 8-months follow-up after surgery, the patient was continent without tape vaginal exposure.
Vaginal mesh erosion should be considered in a patient who presents with sustained vaginal discharge after being treated with a suburethral sling. It is important to place the tape between the whole thickness of the vaginal mucosa and the urethral in SUI surgery. A shallow placement of the tape may lead to vaginal tape erosion and recurrence of SUI. These complications can be avoided by following the correct manipulation procedure and referring to the tissue layer anatomy.
经阴道无张力尿道悬吊带（TVT）已成为治疗压力性尿失禁（SUI）的一种流行方法。吊带向阴道内侵蚀很少见，极少数患者出现阴道吊带侵蚀和 SUI 复发。
一位 49 岁女性因压力性尿失禁接受了耻骨后尿道下 TVT 吊带治疗。2 个月后，SUI 复发症状再次出现。6 个月后，患者诉阴道反复溢液和异物感。体格检查发现阴道前壁中线左侧有 1cm 长的吊带突出。膀胱尿道镜检查未发现尿道网片侵蚀。取出突出的吊带后发现，吊带的左侧臂位于阴道黏膜层，而不是阴道黏膜全层与尿道之间。切开并取出尿道周围的吊带。同时放置新的耻骨后吊带。术后 8 个月随访时，患者无尿失禁，无吊带阴道暴露。
对于接受尿道下吊带治疗后持续出现阴道溢液的患者，应考虑阴道网片侵蚀。在 SUI 手术中，重要的是将吊带置于阴道黏膜全层与尿道之间。吊带位置较浅可能导致阴道吊带侵蚀和 SUI 复发。通过遵循正确的操作程序和参考组织层解剖结构，可以避免这些并发症。
