PLACEMENT OF A RETROPUBIC DRAIN WITH THE TENSION-FREE VAGINAL TAPE OPERATION

A. Bader, MD, F. Zivkovic, MD, K. Tamussino, MD

   Objective: Intraoperative bleeding and postoperative hematomas are recognized complications of the tension-free vaginal tape (TVT) operation.

   Methods: We devised a connector to secure a drain to the end of the TVT needle. A 10-Charrière drain with an external diameter of 3.5 mm and an internal diameter of 2 mm is attached to the drain connector and the connector is screwed into the end of the TVT needle after the needle has been placed and the introducer has been disconnected. The drain is then pulled upward together with the tape itself so that its end comes to lie in the space of Retzius.

   Results: The connector was used in an initial series of three patients with previous surgery, bladder perforation, or both. The drains were removed the day of surgery and the postoperative courses were uneventful. In all patients the drains were attached to suction. Before removing the drains suction was released in order not to dislocate the implanted tapes.

   Conclusion: A drain connector provides a simple and safe method to place a drain in the space of Retzius during the TVT operation.

   Key Words: Tension-free vaginal tape; TVT; Hematoma