Erosion or insertion of the tape mesh to adjacent organs is one of the serious possible complications of tangent-free vaginal tapes. Management of such complication is difficult. The aim of this video is to provide a step-by-step description of our approach to laparoscopical removal of intraureterally localized retropubic tape after previous failure of repeated transvaginal and uretroscopic tape resection. A 61-year-old woman was referred to our department with tape erosion followed after the insertion of retropubic tape in 2004 and several attempts of tape removal. One exam before the procedure described presence of the tape residue in the middle of the urethra, approximately 14 mm below the bladder neck. Urethroscopy revealed the presence of stone with tape in the urethra wall, approximately in the 11 o'clock position. Laparoscopy was performed using a 10 mm port inserted in the inferior edge of the umbilicus to accommodate the laparoscope and three other ports, one 10 mm and two 5 mm. After the filling of urinary bladder with 150 ml of sterilized saline, the peritoneum was opened above the urinary bladder and Ratio's pace was reached. Tape was identified, at first the right arm of the tape which passes directly to the urethra. The right arm was cut above the pubic bone and dissected step by step up to the urethra wall and afterwards resected from the urethra wall. Visual control allows to decrease the bleeding during the procedure. It is also possible to provide the palpation control, the presence of the urethra, the position of the urethra and finally the tape was dissected from the urethra wall. Afterwards, the left arm of the tape was identified and again the careful dissection was provided and the tape was removed from the vaginal wall. And step by step careful dissection of the tape from the adjacent tissue. Afterwards, the bleeding was controlled using the bipolar coagulation. Defect in the urethra wall after the tape resection was identified using the Haggard dilatator and was closed using 3-0 Vicryl suture. The postoperative course was uneventful. In follow-up visit three months after the surgery, the patient had significantly improved OAB symptoms, no urgency incontinence, persistent stress urinary incontinence. Also disappeared chronic pain in the lower abdomen. Urethroscopic and transvaginal resection of protruded mesh is inadequate in many cases. Remaining tape could cause further complication. In such cases, it's required to remove the mesh from the urethra completely. Laparoscopy removal is an effective, minimally invasive option for management of such complication.

laparoscopic removal

retropubic tape

urethra erosion

bipolar coagulation

urethra wall closure