Vaginal Mucosal Flap as a Sling Preservation for the Treatment of Vaginal Exposure of Mesh
김세영, 박종연, Kim Han-Kwon, 박창후, 김성진, 성기택, 박창면,
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김세영 ( Kim Sea-Young )
울산대학교 의과대학 강릉아산병원 비뇨기과학교실
박종연 ( Park Jong-Yeon )
울산대학교 의과대학 강릉아산병원 비뇨기과학교실
( Kim Han-Kwon )
울산대학교 의과대학 강릉아산병원 비뇨기과학교실
박창후 ( Park Chang-Hoo )
울산대학교 의과대학 강릉아산병원 비뇨기과학교실
김성진 ( Kim Sung-Jin )
울산대학교 의과대학 강릉아산병원 비뇨기과학교실
성기택 ( Sung Gi-Teck )
울산대학교 의과대학 강릉아산병원 비뇨기과학교실
박창면 ( Park Chang-Myon )
울산대학교 의과대학 강릉아산병원 비뇨기과학교실
KMID : 0358320100510060416
Abstract
Purpose: Tension-free vaginal tape (TVT) procedures are used for the treatment of stress urinary incontinence in women. The procedures with synthetic materials can have a risk of vaginal erosion. We experienced transobturator suburethral sling (TOT) tape-induced vaginal erosion and report the efficacy of a vaginal mucosal covering technique.
Materials and Methods: A total of 560 female patients diagnosed with stress urinary incontinence underwent TOT procedures at our hospital between January 2005 and August 2009. All patients succeeded in follow-ups, among which 8 patients (mean age: 50.5 years) presented with vaginal exposure of the mesh. A vaginal mucosal covering technique was performed under local anesthesia after administration of antibiotics and vaginal wound dressings for 3-4 days.
Results: Seven of the 8 patients complained of persistent vaginal discharge postoperatively. Two of the 8 patients complained of dyspareunia of their male partners. The one remaining patient was otherwise asymptomatic, but mesh erosion was discovered at the routine follow-up visit. Six of the 8 patients showed complete mucosal covering of the mesh after the operation (mean follow-up period: 16 moths). Vaginal mucosal erosion recurred in 2 patients, and the mesh was then partially removed. One patient had recurrent stress urinary incontinence.
Conclusions: Vaginal mucosal covering as a sling preservation with continued patient continence may be a feasible and effective option for the treatment of vaginal exposure of mesh after TOT tape procedures.
키워드
Complications;Suburethral slings;Surgical mesh
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