Menahem Neuman

Infected hematoma following tension-free vaginal tape implantation.

The tension-free vaginal tape procedure for surgical correction of female urinary stress incontinence, a minimally invasive operation with high success and low complication rates, was first described in 1995.1 Common complications of procedures formerly used to treat urinary stress incontinence are extremely rare in the tension-free vaginal tape era.2 However, 2 cases of noninfected hematoma following the tension-free vaginal tape procedure have been described.3 We report 2 cases of infected hematoma following the tensionfree vaginal tape procedure that resolved with appropriate management. To our knowledge these are the first such cases reported in the literature. A total of 238 tension-free vaginal tape procedures were performed at 2 institutions between April 1998 and February 2002. Of the operated patients 2 (0.84%) suffered from postoperative infected hematoma. In neither case was previous corrective surgery or intraoperative bladder penetration recorded. CASE REPORTS

Low incidence of post-TVT genital prolapse

Tension-free vaginal tape (TVT) is a well established surgical procedure for the treatment of female urinary stress incontinence. The operation, described by Ulmsten in1995, is based on a midurethral Prolene tape support. TVT is accepted as an easy-to-learn and safe, minimally invasive surgical technique. Postoperative genital prolapse has been described following the Burch technique, as well as other surgical methods for the correction of female stress urinary incontinence. The aim of this analysis was to evaluate the occurrence of this specific complication in relation to TVT. Of 314 patients undergoing TVT and followed for up to 50 months only 1 suffered genital prolapse, with de novo grade 2 cystocele, rectocele and uterine prolapse, diagnosed 3 months after the operation. This is the first reported case of genital prolapse following TVT.