Alternative method of suprapubic assistance in operative cystoscopy

Complications of tension-free vaginal tape (TVT) procedures have become more prevalent as the procedure has become more popular for the treatment of stress urinary incontinence. A common complication of TVT slings is bladder perforation, which is estimated to occur in 0.7–24% of treated patients. While easily treated if identified intraoperatively, unrecognized bladder perforation generally requires further surgery to correct. We propose a novel minimally invasive technique using the suture passer of the Carter–Thomason CloseSure system for suprapubic assistance during cystoscopic removal of TVT mesh from the bladder. This novel approach allows for the avoidance of an open incision or a larger accessory port placed through the bladder to assist with mesh excision.