Transobturator tape material detected in the bladder neck: a case report.

ABSTRACT

INTRODUCTION: Stress urinary incontinence surgeries (transobturator tape and tension-free vaginal tape) are safely performed with success rates over 90%. The transobturator tape procedure attracted more attention due to the lack of major complications, such as intraabdominal organ and vascular injuries, related to the tension-free vaginal tape procedure. Although there are no major or mortality-related complications, more lower urinary complaints, especially vaginal erosion, are reported in transobturator tape surgery. Here we present a rare complication of transobturator tape surgery the accidental placement of mesh material in the bladder neck. With this case report, we aimed to discuss the diagnosis and management of misplaced transobturator tape material. CASE PRESENTATION A 38-year-old Caucasian woman who had stress urinary incontinence that had persisted for 6 years underwent transobturator tape surgery in a different clinic 2 years ago. Subsequently, she presented to our clinic with lower urinary tract complaints such as incontinence and dysuria. A physical examination was unremarkable besides total incontinence. A diagnostic cystoscopy was performed and sling material that crossed her bladder neck from 3 o'clock to 10 o'clock was identified. The misplaced transobturator tape material was cut endoscopically with an internal urethrotomy knife. Afterwards, a midurethral incision was made and mesh parts were removed bilaterally. After successful removal of the mesh material, a new transobturator tape was placed. CONCLUSIONS: Even though transobturator tape surgery is a safe and effective procedure for stress urinary incontinence, certain complications can be encountered. Misplacement of the mesh material through the bladder neck is a rare complication and can be managed by successfully removing the mesh material and appropriately placing new transobturator tape material.