Robotic Resection of Intravesical Polypropylene Mesh following Tension-Free Tape Procedure

Abstract

To present a case of intravesical TVT mesh remote from insertion and demonstrate one possible technique for resection of the retropubic mesh arms. Tension-free vaginal tape (TVT) is the mainstay of treatment for stress urinary incontinence, and though major complications are rare, most are associated with the blind passage of the TVT trocars through the retropubic space. This video reviews TVT complications and treatment options for intravesical polypropylene mesh. This introduction is followed by a case presentation of a 43 year old para 2 female who underwent laparoscopic robotic removal of TVT after two years after the initial procedure. There are several options for surgical treatment of intravesical mesh issues following TVT, including vaginal, laparoscopic (with or without robotic assistance), and open procedures which can either completely or partially remove the polypropylene mesh depending on the TVT issues in question (intravesical mesh, pelvic pain, dyspareunia, etc.). This video demonstrates our preferred method of laparoscopic robotic assisted removal of the retropubic TVT arms in cases of intravesical mesh remote from initial surgery.