Vaginal Erosion Associated with Tension Free Vaginal Tape Procedure

Jung, Jin Kwan; Lee, Sang Leen; Park, Won Hee; Lee, Tack

Abstract

PURPOSE
Vaginal erosion is known complication of synthetic sling material, Most series report a relatively low erosion rate, ranging from 0 to 11%. but few report on management of only vaginal erosion after TVT procedure have been described. We estimated the incidence of vaginal erosion associated with the use of TVT and investigated clinical outcomes.
MATERIALS AND METHODS
Between 1999~2002, 296 cases (mean age: 48.8 yrs; range: 31~67 yrs) of TVT performed by 2 university were retrospectively reviewed. Post-operative vaginal erosion as well as their management and surgcial outcomes were investigated. We performed only TVT on 173 patients with grade 1, 2 cystocele, and TVT combined cystocele repair on 123 patients with cystocele grade 3, 4.
RESULTS
11 women (3.72%) required secondary interventions due to vaginal erosion. The interval between insertion and removal varied from 1 to 14 months (mean 6.24), 6 patients developed before postoperative three months. Among 11 patients, 7 patients had TVT combined cystocele repair (one vertical incision), and the others had TVT only. A transvaginal approach was used for vaginal flap over TVT in 2 patients (secondary vaginal erosion developed after 2 months) and a vaginal flap in 1 patient (secondary vaginal erosion developed after 7 months), and TVT removal in 8 patients. Before and after secondary intervention, all patients were totally dry (mean FU period: 12.5 months).
CONCLUSION
We suggest that vaginal erosion after TVT procedure should be treated with complete removal of the tape.