[VS-007]Mesh Excision After Previous TVT SurgeryAytaç Kayış1, Ömer Gülpınar2, Barış Esen2, Mehmet İlker Gökçe2, Evren Süer2, Uygar Bağcı22Department of Urology, Ankara University, Ankara, Turkey PURPOSE: To present a case with difficulty in urination after TVT surgery in which physical examination revealed a palpable mesh under urethra Patient: 60 years old female has underwent TVT surgery in 2006, since then has complaints of difficulty in urination. Urethral dilatation had been performed to the patient but her symptoms has not improved. Physical examination revealed significant kinking. Mesh was palpable on the left of urethra. Obstructive pattern was seen in UFM.(7/130/256). Transvaginal ultrasonography revealed mesh at the posterior of urethra. Mesh removal was planned. Surgical Procedure: Patient was prepped in lithotomy position and 21F urethroscope was inserted. Significant kink formation was observed due to mesh. 14F urethral catheter was placed and Lone Star Retractor System™ placed. Vaginal mucosa under the urethra was marked in inverse U shape and incised with cautery. Than vaginal flap was prepared. Mesh was identified and dissected all through to the most proximal part possible and excised. Physical examination was done for any possible residual mesh. Than urethroscope was inserted and no urethral defect was seen. İt had been noticed that previous kink formation was also resolved. Spongious defect was repaired. İncision plate and vaginal mucosal flap was sutured using 5/0 vicryl suture. A vaginal tampon was placed and procedure was ended. CONCLUSION: Excesive tension during midurethral sling surgeries can cause infravesical obstruction. Mesh excision is an effective solution for the treatment of this problem Mesh Excision |