The tension-free vaginal tape was introduced in 1995 by Ulmsten and Petros for female stress urinary incontinence (SUI)(1). In the following decades, mid-urethral tapes (MUT) became the gold-standard procedure for stress urinary incontinence (2). There are many reported serious complications associated with them(3). Surgical management may involve total or partial tape excision, with its associated risks (4).

Our video presentation demonstrates a case of laparoscopic removal of retropubic tape, which was found perforating the bladder.

The laparoscopic removal of retropubic tape was recorded and the video edited to comply with the ICS conference submission requirements. A specialised medical illustration consent was obtained from the patient for the use and publication of the recording. The music piece used in the video is part of the public domain and is credited at the end of the video.

Case presentation

We present a case of 54 years old patient who was referred with persistent UTI and vaginal and pelvic pain. MRI and cystoscopy confirmed bladder perforation of the left arm of the tape into the bladder, as demonstrated in the cystoscopy sequences of the video. Case was discussed in MDT which agreed to support the patient’s choice for mesh removal. 

We present a challenging case of laparoscopic removal of retropubic tape which shows the technique of laparoscopic dissection, excision of the tape from the bladder wall and into the retropubic space and repair of the bladder defect.

Laparoscopic total removal of retropubic tape is a technique that can be utilised, even with cases of urinary tract perforation like this case. We present a challenging case of  laparoscopic retropubic tape removal with known urinary bladder mesh perforation.

Ulmsten U, Henriksson L, Johnson P, Varhos G. An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 1996;7(2):81-5; discussion 5-6.
Rogo-Gupta L, Litwin MS, Saigal CS, Anger JT, Urologic Diseases in America P. Trends in the surgical management of stress urinary incontinence among female Medicare beneficiaries, 2002-2007. Urology. 2013;82(1):38-41.
Ross S, Tang S, Eliasziw M, Lier D, Girard I, Brennand E, et al. Transobturator tape versus retropubic tension-free vaginal tape for stress urinary incontinence: 5-year safety and effectiveness outcomes following a randomised trial. Int Urogynecol J. 2016;27(6):879-86.