The transobturator tape (TOT) is an effective treatment for stress urinary incontinence (SUI). Erosion of TOT mesh is a recognised complication requiring excision. A retrospective analysis of 228 females undergoing a TOT procedure over 4 years identified 16 patients (7%) that underwent excision of eroded mesh.
Mean age of patients requiring excision was 48. 8 years and mean weight was 72. 7kg. Mean time to re-presentation was 14. 5 months. Presenting symptoms included dyspareunia in 9 patients (56. 2%), dysuria in 3 (18. 7%), persistent incontinence in 3 (18. 7%) and groin pain in one patient. Ten patients (62. 5%) had a prior urogynecological procedure. After excision of eroded tape-mesh, 7 (43. 7%) required a rectus fascial sling and 4 (25%) underwent repeat TOT for recurrence of SUI. Five patients (31. 2%) required no further surgery. At present 10 patients (62. 5%) report resolution of SUI, 4 (25%) report mild SUI and 2 (12. 5%) patients have moderate/severe SUI. Resolution of symptoms occurred in the majority of patients after excision of eroded mesh and an additional anti-incontinence procedure.
Irish medical journal. 2015 Oct [Epub]
J C Forde, N F Davis, T A Creagh