Technical Video: Vesicoscopic Excision of an Eroded Tension Free Vaginal Tape (TVT)

AbstractStudy Objective To demonstrate a vesicoscopic excision of an eroded tension free vaginal tape (TVT). Design Technical video demonstrating vesicoscopic excision of an eroded TVT. Setting Urogynaecology and Urology Departments, King’s College Hospital, Denmark Hill, London, SE5 9RS, UK, a tertiary referral centre for Uro-gynaecology. Interventions A 52-year-old woman presented with suprapubic pain, haematuria and recurrent urinary tract infections four years after TVT insertion for stress urinary incontinence. Cystoscopy revealed an exposed tape with calcifications on the right aspect of the bladder. Video-urodynamics demonstrated normal bladder function and no stress incontinence. After counselling she opted to have the portion of tape excised via a vesicoscopic approach. Conclusion Exposed tapes are found in up to 4% of women who have undergone TVT procedures due to primary unrecognised bladder injury or secondary erosion [1]. Management of this complication can result in a succession of invasive procedures. In this case vesicoscopy allowed complete excision of the exposed portion of tape. After mobilisation, the bladder wall was closed without tension, using Mignot-Grange’s extracorporeal knotting technique. The stumps of the tape were buried deeply to prevent recurrent erosion.