Novel repair of tension-free midurethral sling erosion into the urethra.

Severe urinary tract injury is a relatively uncommon occurrence after the placement of a tension-free vaginal tape sling. Bladder perforation is the most common urinary tract injury, but bladder drainage for a few days is usually the only intervention that is required. Urethral erosions of synthetic sling tapes are much rarer, but can result in more significant sequelae such as voiding dysfunction or fistula formation. A 50-year-old woman had an erosion of a synthetic, tension-free midurethral sling through the urethra. She underwent resection of the sling with closure of the urethral defect. The internal urethral sphincter was used during the primary repair to cover the defect because of periurethral scarring and fibrosis. This technique may reduce the risk of subsequent fistula formation, and may be a less invasive alternative to the use of a Martius interposition flap.