The introduction of innovative surgical techniques in urogynaecology

Piet Hinoul keek naar zes innovaties in de urogynaecologie en constateert dat deze goed uitpakten voor patiënten die kampen met urine-incontinentie en/of bekkenbodemverzakking. Anderzijds stelt hij dat niet iedere innovatie tot verbetering heeft geleid en dat nieuwe technieken ook nieuwe vormen van ziektelast met zich meebrengen. Desondanks is de algemene trend dat de behandeling van bekkenbodemproblemen verbetert. Hinoul benadrukt dat elke innovatie kritisch dient te worden bekeken tot meerdere centra goede resultaten melden

Persistent groin pain following a trans-obturator sling procedure for stress urinary incontinence: a diagnostic and therapeutic challenge

Groin pain after a tension-free vaginal tape-obturator (TVT-O) procedure can occur but mostly disappears within 4 weeks. Persistent groin pain is extremely rare and there is a paucity of literature on how to diagnose and manage this adverse event. We present two cases with severe persistent groin pain after uncomplicated TVT-O, in which magnetic resonance imaging and electromyography did not reveal the cause. We concluded that the tape entrapped or cut through peripheral branches of the obturator nerve. We removed as much of the tape as possible in both cases. Removal partially relieved the pain although sensory loss of the obturator nerve persisted 1 year after surgery. In case of abnormal post-operative groin pain, soon removal of the tape enhances the chance that damage to the obturator nerve is reversible, although it is important to counsel patients with similar pathology that recovery can take long and may be only partia