Secondary Transobturator Tape Procedure after Combined Pelvic Organ Prolapse Repair

• Published in: Lower urinary tract symptoms Vol. 5; no. 1; pp. 52 - 54
• Main Authors: SAITO, Tetsuichi, NISHIZAWA, Osamu, ISHIKAWA, Masakuni, SHIMOJIMA, Yuji, OGUCHI, Tomohiko, SUZUKI, Hisanori, YOKOYAMA, Hitoshi, ICHINO, Midori, KATO, Haruaki, ISHIZUKA, Osamu
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-01-2013; Wiley Subscription Services, Inc
• Subjects: anterior and posterior tension-free vaginal mesh; intrinsic sphincter deficiency; stress urinary incontinence; transobturator tape; Urinary incontinence; Women; anterior and posterior tension-free vaginal mesh; transobturator tape; stress urinary incontinence; intrinsic sphincter deficiency
• ISSN: 1757-5664; 1757-5672
• DOI: 10.1111/j.1757-5672.2012.00161.x

A 66‐year‐old female who underwent a partial urethrectomy complained of severe incontinence due to intrinsic sphincter deficiency. Bone anchor surgical technique was performed, but in 3 years, serious pelvic organ prolapse had occurred. Consequently, anterior and posterior tension‐free vaginal mesh operation was planned. Preoperative urodynamic examination predicted postoperative stress incontinence, and concurrent transobturator tape (TOT) surgery was performed. After 3 months, stress incontinence reoccurred, and secondary TOT was performed. Relapse was probably caused by dislocation of the first TOT towards the bladder neck. Thus, the secondary TOT was placed distal to the initial tape towards the external urethral meatus, and proper tension was applied. After the operation, stress incontinence was cured. Thus, a second TOT procedure, with proper positioning and tensioning, can effectively cure stress incontinence that occurs after an initial TOT procedure.