Late urethral erosion of transobturator suburethral mesh (Obtape^®): a minimally invasive management under local anaesthesia

The placement of transobturator sub-urethral synthetic tapes, although with a high success rate of achieving continence, carries the risk of tape erosion to adjacent structures. While vaginal erosion occurs more frequently, urethral erosion has also been reported, usually in the immediate or early postoperative period. We present two different cases of urethral erosion with the Obtape^® sling, the first one diagnosed 1 year after surgery and the second one, a very late complication, occurring 4 years after the placement of the sling. Although transvaginal urethrotomy with tape resection has been the most popular approach described in the literature, we describe a minimally invasive trans-urethral approach for the management of this complication under local anaesthesia. We also present some “tricks of the trade” on retrieving the tape trans-urethrally while maximizing the length of tape removed.