Treatment of urethral obstruction following tension-free vaginal tape procedure: A report of two cases

Although obstruction following the tension-free vaginal tape (TVT) procedure may iraprove or resolve spontaneously within one month, some cases demonstrate prolonged obstructive or irritative symptoms due to urethral obstruction. We present two cases with persistent voiding difficulty following the TVT procedure. Both were successfully treated by transvaginal sling ralease. Sling release was undertaken 10 and 12 months after the TVT procedure in the two cases, respectively. In the first case, a 72-year-old woman, the tape was buried into the back of the vaginal wall and it was impossible to dissect it off the wall. We dissected the plane between the tape in the vaginal wall and the periurethral fascia up beneath the endopelvic fascia. In the second case, a 49-year-woman, the tape was easily identified above the periurethral fascia and incised in the midline. Both cases achieved a satisfactory voiding condition immediately after the sling release. The tape position in the first case was rare, according to the literature.