{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,26]],"date-time":"2025-07-26T08:40:26Z","timestamp":1753519226490},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"10","license":[{"start":{"date-parts":[[2018,10,19]],"date-time":"2018-10-19T00:00:00Z","timestamp":1539907200000},"content-version":"vor","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by\/NC-ND 4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geburtshilfe Frauenheilkd"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Introduction The complication of tape erosion in the urethra following placement of a retropubic (TVT) or transobturator (TOT) tension-free suburethral vaginal sling or an accidental iatrogenic transurethral tape position can result in the formation of a urethrovaginal or vesicovaginal fistula. The objective of the investigation is the evaluation of the management of such rare complications.<\/jats:p><jats:p>\n          Patients and Methods Retrospective analysis of 14 patients who were treated for a urethral lesion or urethrovaginal fistula formation status post TVT\/TOT placement between June 2011 and February 2018 in the T\u00fcbingen University Department of Gynaecology.<\/jats:p><jats:p>\n          Results As surgical therapy, 57.1% (n\u2009=\u20098) cases underwent vaginal fistula closure using a Martius flap of the labium majus and in 21.4% (n\u2009=\u20093) using a vaginal rotation skin flap. In 21.4% (n\u2009=\u20093), exclusively vaginal suture reconstruction of the urethra following excision of the tape running transurethrally or tape erosion was performed. 50% (n\u2009=\u20097) of the patients had lasting continence postoperatively without any further need for therapy. In 28.6% (n\u2009=\u20094), there was ongoing stress urinary incontinence, in 21.4% (n\u2009=\u20093) mixed urinary incontinence. Six of the 7 patients with persistent incontinence underwent new placement of a tension-free suburethral retropubic sling (TVT) an average of 8.8 months (5\u200a\u2013\u200a13 months) postoperatively which was uncomplicated in all patients and achieved satisfactory continence. The 3 patients with mixed urinary incontinence and persistent urgency components additionally received anticholinergic medication. During the time period investigated, there were no long-term complications, in particular no recurrent fistulas.<\/jats:p><jats:p>\n          Conclusion The rare but relevant complications of a urethral erosion, transurethral tape position or urethrovaginal fistula formation status post TVT\/TOT placement can be successfully managed via vaginal surgery. Persistent postoperative urinary incontinence with the need for a two-phase repeat TVT placement following sufficient wound healing must be preoperatively clarified.<\/jats:p>","DOI":"10.1055\/a-0704-3461","type":"journal-article","created":{"date-parts":[[2018,10,19]],"date-time":"2018-10-19T23:30:34Z","timestamp":1539991834000},"page":"991-998","source":"Crossref","is-referenced-by-count":6,"title":["Management of Urethral Lesions and Urethrovaginal Fistula Formation Following Placement of a Tension-Free Suburethral Sling: Evaluation From a University Continence and Pelvic Floor Centre"],"prefix":"10.1055","volume":"78","author":[{"given":"Dorit","family":"Sch\u00f6ller","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, University of T\u00fcbingen, T\u00fcbingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Brucker","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, University of T\u00fcbingen, T\u00fcbingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christl","family":"Reisenauer","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, University of T\u00fcbingen, T\u00fcbingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2018,10,19]]},"container-title":["Geburtshilfe und Frauenheilkunde"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-0704-3461.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2018,11,22]],"date-time":"2018-11-22T07:09:23Z","timestamp":1542870563000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-0704-3461"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10]]},"references-count":0,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2018,9,20]]},"published-print":{"date-parts":[[2018,10]]}},"URL":"https:\/\/doi.org\/10.1055\/a-0704-3461","relation":{},"ISSN":["0016-5751","1438-8804"],"issn-type":[{"value":"0016-5751","type":"print"},{"value":"1438-8804","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,10]]}}}