Martius graft for the management of tension-free vaginal tape vaginal erosion.

Abstract

The tension-free vaginal tape (TVT) procedure has become standard for the treatment of stress urinary incontinence in women. The procedure carries a risk of vaginal erosion and exposure of the mesh. When this occurs, most surgeons recommend removal of the tape for immediate relief of symptoms. However, this poses a risk of recurrence of urinary incontinence. A premenopausal woman had an exposed vaginal mesh after a TVT procedure. After failed conservative treatment, she was treated successfully using a Martius graft, with preservation of the mesh. The Martius procedure was a practical alternative for treating this patient with synthetic-mesh-induced vaginal erosion. It allowed preservation of the sling, thereby preventing recurrence of urinary incontinence.