Normal Vaginal Delivery After a Tension-Free Vaginal Tape Procedure: Case Report and Literature Review
Wissenschaftlicher Artikel/Review - 01.02.2013
Schyrba Viktor, Bolla Daniele, Drack Gero, Eisele Lilly, Hornung René
Background: Tension-free vaginal tape (TVT) is a widely used method for the surgical treatment of stress urinary incontinence (SUI). TVT is to considered to be a safe and effective procedure, with an enduring high success rate. This article presents a case of a woman, who had an uncomplicated vaginal delivery 3 years after having underwent a TVT procedure. Case: A 41-year-old woman, gravida 4, para 1, with an uneventful pregnancy course was referred to the hospital at 39 2/7 weeks of gestation because of premature rupture of the membranes. Her past history was characterized by an uncomplicated and successful TVT procedure performed 3 years prior, which was inserted after her first delivery to treat severe SUI. One month before the current delivery, a urogynecologist of the hospital visited the patient and considered a vaginal delivery to be possible. No signs of SUI were noted. Results: Five hours after admission to the hospital, this patient had an uncomplicated vaginal delivery of a healthy newborn. Three days later, she was discharged in good condition without any signs of incontinence. The patient had a clinical and sonographic examination 6 weeks after the delivery, and the TVT was still in a correct position without evidence of recurrence of SUI. Conclusions: A vaginal delivery after TVT seems to be possible without an increased risk of recurrence of SUI. Therefore, a TVT procedure, even if childbearing is not completed, can be an interesting therapeutic option. A study with a long term follow-up is needed to confirm this.