PubMed · 3761489
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1986-10-10. Consent: informed, implied, and deferred.. https://pubmed.ncbi.nlm.nih.gov/3761489/
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Urethral erosion by a fascial sling is a rare postoperative complication, and its repair can become a major surgical endeavor. We present a case of autologous fascial sling erosion into the mid-urethra in a 46-year-old woman that was diagnosed after traumatic urethral catheterization. After 3 months of conservative management failed, we released the sling tension surgically by bilateral excision of the graft, leaving the midline structures undisturbed. This allowed resumption of normal voiding, with complete long-term symptomatic relief.
The injured pregnant patient is actually two patients--both in need of expert care. Initial management should be performed as a team effort, with prompt obstetrical consultation available if the mother is seriously injured. The ABCs of resuscitation must be followed in the pregnant patient, just as they are in other injured patients, and the gravid uterus should not cause undo alarm or distraction. Diagnostic studies necessary for the evaluation of the mother should not be withheld, and timely operative intervention (if indicated) offers the best chance of a favorable outcome for mother and fetus.
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