Extraperitoneal laparoscopic removal of eroded midurethral sling: A new technique

Purpose: Erosion of a midurethral sling is common in women who are treated for stress urinary incontinence. This complication is usually managed by retropubic exploration. We report a novel technique to manage erosion in patients who refuse retropubic exploration. Patients and Methods: Two women (ages 47 and 53 years) with stress urinary incontinence were treated with a midurethral sling. Postoperatively, at 24 and 22 months, respectively, the sling had eroded through the high urethra near the bladder neck. A three-port extraperitoneal laparoscopic approach was used to remove the urethral slings and repair the bladder. Results: The procedure was accomplished in 80 and 75 minutes, respectively, with no complications. Both patients remained continent. Conclusion: A minimally invasive extraperitoneal surgical technique can be used to manage midurethral sling erosion in women.