Case report of voiding difficulty after intravaginal slingplasty (IVS) procedure: the emphasize of pre-service training.

ABSTRACT

BACKGROUND: The Intravaginal slingplasty procedure (IVS) is a minimally invasive surgery for the treatment of stress urinary incontinence (SUI). Too much tension during pulling the tape and the incorrect placing of the tape can cause urinary retention that may require release of the tape. CASE REPORT A fifty one years old women with SUI had undergone IVS procedure in a private hospital. After the surgery, urinary retention occurred with prolonged catheterization for 20 days. The patient came to King Chulalongkorn Memorial Hospital on the 21st day after the operation. Surgical release of the tape which was located at the urethrovesical junction rather than the midurethera was done. The patient remained stress continent after the tape was released confirmed by the videourodynamic study one month later. CONCLUSION: Too much tension, insertion of the tape too close to the urethrovesical junction or the tape migration may be the causes of prolonged urinary retention after IVS procedure. The authors found the surgical release of the tape to be the effective management for this complication. Pre-service training in models and practice under the supervision of an experienced surgeon are needed before attempting any on their own. From the authors extensive review, this is the first case report of urinary retention after IVS procedure that required tape incision.