International Urogynecology Journal

, Volume 21, Issue 3, pp 371–373

Small bowel perforation in a hernia sac after TVT placement at the time of colpocleisis

  • Emil L. Gurshumov
  • Allan S. Klapper
  • Ava R. Sierecki
Case Report

DOI: 10.1007/s00192-009-0956-0

Cite this article as:
Gurshumov, E.L., Klapper, A.S. & Sierecki, A.R. Int Urogynecol J (2010) 21: 371. doi:10.1007/s00192-009-0956-0

Abstract

Tension-free vaginal tape (TVT) is commonly considered as the first line of treatment for stress urinary incontinence (SUI) with demonstrated efficacy and limited complications. An 82-year-old woman with complete uterine procidentia and SUI underwent a Le Forte colpocleisis, TVT, posterior repair, and cystoscopy. A 4-cm bulge was noted over the site of the left TVT incision on postoperative day 1. On postoperative day 3, she developed bilious vomiting with slight abdominal distention. Computed tomography scan showed a strangulated left inguinal hernia. An immediate exploratory laparotomy noted an inguinal hernia displaced medially with loops of small bowel in the hernia sac. Although properly positioned, one loop of bowel was perforated by the sling mesh. A small bowel resection was performed and the mesh trimmed below the resection on involved side. At 2 months postoperative visit, the patient was asymptomatic, denied stress or urge incontinence. Vaginal examination noted well-supported vaginal walls.

Keywords

TVT Vaginal sling Bowel injury Hernia perforation 

Copyright information

© The International Urogynecological Association 2009

Authors and Affiliations

  • Emil L. Gurshumov
    • 1
  • Allan S. Klapper
    • 1
  • Ava R. Sierecki
    • 1
  1. 1.Department of Obstetrics and GynecologyNew York Downtown HospitalNew YorkUSA

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