Case Report of Voiding Difficulty after Intravaginal Slingplasty (IVS) Procedure: The Emphasize of Pre-service Training
Suvit Bunyavejchevin, MD, MHS*, Apirak Santingamkun, MD**
Affiliation : * Department of Obstetric and Gynecology, Faculty of Medicine, Chulalongkorn University ** Department of Surgery, Faculty of Medicine, Chulalongkorn University
Background : The Intravaginal slingplasty procedure (IVS) is a minimally invasive surgery for the treatment
of stress urinary incontinence (SUI). Too much tension during pulling the tape and the incorrect placing of
the tape can cause urinary retention that may require release of the tape.
Case Report : A fifty one years old women with SUI had undergone IVS procedure in a private hospital. After
the surgery, urinary retention occurred with prolonged catheterization for 20 days. The patient came to King
Chulalongkorn Memorial Hospital on the 21st day after the operation. Surgical release of the tape which was
located at the urethrovesical junction rather than the midurethera was done. The patient remained stress
continent after the tape was released confirmed by the videourodynamic study one month later.
Conclusion : Too much tension, insertion of the tape too close to the urethrovesical junction or the tape
migration may be the causes of prolonged urinary retention after IVS procedure. The authors found the
surgical release of the tape to be the effective management for this complication. Pre-service training in
models and practice under the supervision of an experienced surgeon are needed before attempting any on
their own. From the authors extensive review, this is the first case report of urinary retention after IVS
procedure that required tape incision
Keywords : Stress urinary incontinence, Intravaginal slingplasty, IVS
