[一例因压力性尿失禁而接受 TVT 手术 15 年后诊断为阴道网片暴露的病例]。

Hiroki Sai, Kumiko Kato, Ayako Momota, Aika Matsuyama, Haruka Kurosu, Takashi Kato, Satoshi Inoue, Hiroki Hirabayashi, Shoji Suzuki
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引用次数: 0

摘要

尿道中段吊带术被视为治疗女性压力性尿失禁的标准疗法。然而,必须就网片并发症的可能性征得患者的知情同意。此外,一般医务人员也需要了解这些并发症。15 年前,一名 59 岁的绝经后妇女在我科接受了治疗压力性尿失禁的 TVT 手术。由于 10 年后开始出现生殖器出血,她到另一家医院的妇科医生处就诊,后因阴道糜烂转诊至我科。盆腔检查时,在阴道前壁右侧可触及条索状结构。使用膀胱镜检查阴道时,清晰可见附着在阴道前壁的异物。在确诊为阴道网片暴露后,她接受了经阴道的 TVT 胶带部分切除术。在 6 个月的随访中,她没有再出现网片外露或压力性尿失禁。虽然日本的文献很少报道这种情况,但医疗从业人员必须谨慎对待尿道中段吊带术后很长时间内可能发生的网片暴露。
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[A CASE OF VAGINAL MESH EXPOSURE DIAGNOSED 15 YEARS AFTER TVT SURGERY FOR STRESS URINARY INCONTINENCE].

Midurethral sling procedures are regarded as standard therapies to treat female stress urinary incontinence. However, informed consent must be gained from the patients concerning the possibility of mesh complications. Furthermore, understanding of these complications is required by medical practitioners in general. A 59-year-old postmenopausal woman had undergone TVT surgery to treat stress urinary incontinence in our department 15 years ago. Due to genital bleeding which started 10 years later, she visited a gynecologist in another hospital and was referred to us due to vaginal erosion. During the pelvic examination, a cord-like structure was palpable on the right side of the anterior vaginal wall. Upon inspection of the vagina using a cystoscope, the foreign body attached to the anterior vaginal wall was clearly visible. After the diagnosis of vaginal mesh exposure, she underwent a transvaginal partial resection of the TVT tape. She had no recurrence of mesh exposure or stress urinary incontinence in a 6-month follow-up. Although infrequently reported in Japanese literature, medical practitioners must be cautious of mesh exposure that can occur long after midurethral sling procedures.

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