Urethral diverticulum after midurethral sling erosion, excision, and subsequent management

Background: Urethral diverticulum formation after midurethral sling placement is a very rare complication. Only 3 previous cases have been reported in the English literature. This is the first reported case of urethral diverticulum formation after midurethral sling excision for urethral erosion. Case: A 43-year-old female patient presented with recurrent stress incontinence after midurethral tension-free vaginal tape sling removal for urethral erosion. Retrograde urethrogram demonstrated a urethral di-verticulum. Video urodynamics showed a Valsalva leak point pressure of 50 cm H₂O at 250 mL. She subsequently underwent urethral diverticulectomy with pubovaginal sling placement. Conclusions: We present the first reported case of urethral divertic-ulum formation after midurethral sling excision for urethral erosion. Future consideration must be given to full excision of the sling tract during the sling removal operation in cases of urethral erosion to prevent this rare complication.