TVT手術後の腟壁びらん

A case of vaginal erosion following the TVT operation

喘息発作，走行での腹圧性尿失禁を主訴とした47歳，女性。TVT手術施行9週後，性交相手が陰茎にチクッとした痛みを感じるとの訴えで受診し，前腟壁右側にメッシュが透見された。3週後に，さらに浮いてきた露出部を牽引切除した（13×7mm）。びらんは治癒し，尿失禁の再発もなかった。腟壁びらんの合併症はTVT手術では少ないが，性交相手の違和感などに注意し，視触診や膀胱鏡による腟内観察で確認する必要がある。

A 47-year-old premenopausal woman underwent the TVT operation due to stress urinary incontinence during asthma attacks and walking. Nine weeks postoperatively she visited a hospital due to her partner experiencing prickling pain during sexual intercourse. A vaginal examination revealed vaginal mucosal erosion of the polypropylene mesh that became more evident during 3 weeks of observation. Cystoscopy was useful for diagnosing the extent of the erosion. The exposed mesh,13×7 mm in size,was excised by forceps,and complete recovery of the vaginal erosion was confirmed 3 weeks later without recurrence of stress urinary incontinence. Since the TVT operation is becoming popular in the treatment of female stress urinary incontinence in Japan,its relatively rare complications such as vaginal erosion should be monitored.