[Management of postoperative objectified intravesical position of the TVT tape--two case reports]. / Management bei postoperativ diagnostizierter intravesikaler TVT-Bandlage anhand zweier Kasuistiken.

Recurrent urinary tract infections and symptoms of a hyperactive bladder in women having undergone a TVT (tension-free vaginal tape) procedure may be due to intravesical position of the tape. Urogenital ultrasound can provide early preliminary diagnostic evidence, which can then be confirmed by subsequent urethrocystoscopy. Minimally invasive revision can be achieved by transurethral resection of the intravesical TVT portions. Tape portions near the wall can be removed after stretching of the tape with grasping forceps inserted through a suprapubically placed trocar. This simple procedure can spare the patient a more extensive repeat operation for removal of the intravesical TVT that may even require a combined abdominovaginal approach.

Endoscopic resection of a vaginal septum in a bitch and observation of septa in two related bitches.

CASE HISTORY: In 2008, a 3-year-old female Labrador Retriever was presented for routine breeding soundness evaluation. CLINICAL FINDINGS: Vaginal endoscopy revealed an 8-cm long and 1-cm thick vaginal septum. Surgical resection of the septum was performed under general anaesthesia using a bipolar high-frequency resectoscope. Three months later the bitch was naturally mated and subsequently delivered five male and two female puppies without complications. Both female puppies were examined at the age of 12 and 15 months and showed a vaginal septum with a diameter of 0.3 and 0.5 cm, respectively. DIAGNOSIS: Vaginal septa in three related bitches. CLINICAL RELEVANCE: This is the first report describing the use of a bipolar high-frequency resectoscope for vaginal surgery in dogs. The septum could be resected quickly, with preservation of surrounding structures. Furthermore, it is the first report collecting information about familial presentation of vaginal septa in female dogs. Based on this case, we suggest that consideration should be given to the possible risk of inheritance of vaginal septa before considering surgical resection and breeding of female dogs.

Follow-up after polypropylene mesh repair of anterior and posterior compartments in patients with recurrent prolapse.

To retrospectively analyze the outcome of surgery in women followed up for 1 year after vaginal repair with the Apogee (support of posterior vaginal wall) or Perigee (support of anterior vaginal wall) system. A total of 120 patients with recurrent cystocele and/or rectocele or with combined vaginal vault prolapse were treated by either posterior or anterior mesh interposition depending on the defect. Follow-up after 1 year (+/-31 days) comprised a vaginal examination with prolapse grading using the POP-Q system, measurement of vaginal length, evaluation of the vaginal mucosa, and exploration for mesh erosions. Postoperatively, 112 (93%) women were free of vaginal prolapse, whereas 8 (7%) had level 2 defects. Erosions occurred significantly more often (p = 0.042) in patients treated with the Perigee system. Our results suggest that the Apogee and Perigee repair systems (monofilament polypropylene mesh) yield excellent short-term results after 1 year.

[Vaginal revision of irritation of the obturator nerve within colposuspension]. / Vaginale Revision bei Irritation des N. obturatorius nach Burch-Kolposuspension.

Irritation of the obturator-nerve within colposuspension is a possible complication because of topographic proximity between obturator-nerve and operating-field. The main symptoms are weakness of the adductor muscles, sensory disturbance of thigh till paralysis and pain in the operating- field early after surgery. Too lateral fixing of the sutures in the pectineal ligament above the obturator-channel can cause compression of the obturator-nerve. Precocious intervention is a precondition for complete remission of symptoms, retropubic revise of surgery is evident. The method outlined here describes vaginal access for re-surgery with lateral colpotomy and dissection of the proximal colposuspension s suture. In this way a recurrent laparotomy with additional trauma of the operating-field can be avoided. In the case described here, this method led to the patients complete remission.