This paper presents the "Central Road" cystoscopic finding accompanied by magnified mixed urinary incontinence following laparoscopic sacrocolopopexy.
A 70-year-old female experienced severe mixed urinary incontinence upon completing laparoscopic sacrocolopopexy. The cystoscopy showed a cord-like appearance in the center of the bladder trigon and posterior wall. Videourodynamics confirmed stress urinary incontinence, and chain cystourethrography indicated that the proximal urethra was open and the posterior vesicourethral angle was atypically widened. After implanting a midurethral sling, mixed urinary incontinence was cured subjectively and objectively without medication.
The "Central Road" cystoscopic finding can be a signpost pointing to laparoscopic sacrocolopopexy mesh overtensioning, which can cause dekinking of the bladder neck, exacerbate stress urinary incontinence, and possibly lead to stress-induced instability. A midurethral sling successfully relieved mixed urinary incontinence in this case, but it might be necessary to loosen the laparoscopic sacrocolopopexy mesh in some other cases.
IJU case reports. 2020 Jul 01*** epublish ***
Kumiko Kato, Yasukuni Yoshimura, Masahiro Narushima, Shoji Suzuki, Ryohei Hattori
Department of Female Urology Japanese Red Cross Nagoya First Hospital Nagoya Japan., Female Pelvic Health Center Showa University Northern Yokohama Hospital Yokohama Japan., Department of Female Urology and Urogynecology Center Meitetsu Hospital Nagoya Japan., Department of Urology Japanese Red Cross Nagoya First Hospital Nagoya Japan.