Facts, Views & Vision
in ObGyn

Journal of the European Society for Gynaecological Endoscopy

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Robotic-assisted treatment of obturator nerve entrapment 5 years after retropubic tension-free vaginal tape insertion

H. Krentel1,4, C.D. Alt2, D. Andrikos1, A. Naem1,3, K. Otto1, P. Tanovska1, A. S. Constantin4, R. L. De Wilde5

1 Department of Obstetrics, Gynecology, and Gynecologic Oncology, Bethesda Hospital Duisburg, Germany
2 Radiology Wolfgarten, Bonn, Germany
3 Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
4 Clinic of Gynecology, Obstetrics and Reproductive Medicine, University Hospital Saarland, Germany
5 Clinic of Gynecology, Obstetrics and Gynecological Oncology, University Hospital for Gynecology, Pius-Hospital Oldenburg, Medical Campus University of Oldenburg, Oldenburg, Germany.

Keywords:

Obturator nerve entrapment, retropubic TVT, robotic gynaecological surgery


Published online: Dec 18 2024

https://doi.org/10.52054/FVVO.16.4.043

Abstract

Background: Stress urinary incontinence is a frequent condition in female patients. Surgical treatment with tension-free vaginal tape (TVT) insertion is a minimally invasive option with immediate improvement of symptoms. Different possible complications have been described in the literature. Obturator nerve entrapment is a very rare complication of retropubic (rp) TVT insertion.

Objectives: : To show the feasibility of robotic-assisted laparoscopic mesh removal in a case of rpTVT-related entrapment of the left obturator nerve.

Materials and Methods: We present the case of a 55-year-old patient who suffered from left obturator nerve dysfunction with adductor muscle atony and neuralgia after insertion of rpTVT five years earlier in an external hospital for urinary stress incontinence. We show the safety and feasibility of robotic-assisted nerve-sparing mesh removal.

Main outcome measures: Post-interventional pain release and nerve and muscle function recovery.

Results: Immediately after the surgical removal of the mesh and release of the left obturator nerve, the patient reported pain release and improvement of motoric function.

Conclusions: Robotic-assisted surgery is a feasible minimally invasive alternative in the treatment of rpTVT-related obturator nerve entrapment.

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