Vaginal Extrusion of Transobturator Tape 6 Years after Procedure: How Long Should Be the Follow-Up Period after Vaginal Sling Surgeries?

A 77-year-old lady presented to the gynaecology outpatient clinic with vaginal extrusion (3C/T3/S1) six years after a transobturator suburethral sling procedure (TOT). The entire tape was spontaneously extruded vaginally and the vaginal erosion healed with conservative management. Midurethral tapes, currently the standard of care in the management of urodynamic stress incontinence (USI), are associated with a risk of erosion and extrusion of the synthetic material. The present case highlights the importance of the long-term followup after any sling procedure as erosion and/or extrusion may arise at any time following the procedure.

DOUBLE TRANSOBTURATOR APPROACH TO TREATING CYSTOCELE

The aim of this study is to show the safety and efficacy of the double transobturator approach, a new technique for anterior vaginal wall prolapse, using several different kinds of meshes (synthetic and biological).This is a retrospective study of 74 women treated between 2005 and 2007. The patients underwent a 3, 6 and 12 month follow-up. The anatomical cure rate, defined as grade of prolapse <2, was 79.7%. Fifteen patients had a recurrence, 12 were treated with biological VS meshes and 3 were treated with synthetic meshes. Vaginal erosion was reported in 5 (6.7%) of these patients, two of whom were treated with topic estrogenic therapy, and three of whom with partial excision. These results suggest that this technique is safe and efficacious and that the best meshes to use are synthetic meshes, because they have a lower recurrence rate than biological meshes.