Sai Hiroki, Kato Kumiko, Momota Ayako, Matsuyama Aika, Kurosu Haruka, Kato Takashi, Inoue Satoshi, Hirabayashi Hiroki, Suzuki Shoji
Department of Urology, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital.
Department of Female Urology, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital.
Nihon Hinyokika Gakkai Zasshi. 2023;114(2):66-69. doi: 10.5980/jpnjurol.114.66.
Midurethral sling procedures are regarded as standard therapies to treat female stress urinary incontinence. However, informed consent must be gained from the patients concerning the possibility of mesh complications. Furthermore, understanding of these complications is required by medical practitioners in general. A 59-year-old postmenopausal woman had undergone TVT surgery to treat stress urinary incontinence in our department 15 years ago. Due to genital bleeding which started 10 years later, she visited a gynecologist in another hospital and was referred to us due to vaginal erosion. During the pelvic examination, a cord-like structure was palpable on the right side of the anterior vaginal wall. Upon inspection of the vagina using a cystoscope, the foreign body attached to the anterior vaginal wall was clearly visible. After the diagnosis of vaginal mesh exposure, she underwent a transvaginal partial resection of the TVT tape. She had no recurrence of mesh exposure or stress urinary incontinence in a 6-month follow-up. Although infrequently reported in Japanese literature, medical practitioners must be cautious of mesh exposure that can occur long after midurethral sling procedures.
中段尿道吊带手术被视为治疗女性压力性尿失禁的标准疗法。然而,必须就网片并发症的可能性获得患者的知情同意。此外,一般执业医生也需要了解这些并发症。一名59岁的绝经后女性15年前在我院接受了经阴道无张力尿道中段悬吊带术(TVT)治疗压力性尿失禁。10年后因生殖器出血,她前往另一家医院的妇科就诊,因阴道糜烂被转诊至我院。盆腔检查时,在阴道前壁右侧可触及条索状结构。使用膀胱镜检查阴道时,附着在阴道前壁的异物清晰可见。诊断为阴道网片外露后,她接受了经阴道TVT吊带部分切除术。在6个月的随访中,她没有出现网片外露或压力性尿失禁复发的情况。尽管日本文献中对此报道较少,但执业医生必须警惕中段尿道吊带手术后很长时间可能出现的网片外露情况。