Abstract
The transobturator tape (TOT) procedure was described in 2001 as the safest sling technique for the treatment of stress urinary incontinence (SUI). Although routine intraoperative cystoscopy to detect bladder and urethra injuries after the TOT procedure is not usually advocated, when such perforations do occur, there is potential for further patient morbidity. We present a case report of a vesico-cutaneous fistula detected after placement of a TOT sling in a 44-year old woman, 3 months postoperatively. Cystoscopic evaluation after mid-urethral sling procedures, especially in high-risk situations such as patients with cystocele, previous pelvic floor surgery or during the learning curve of the procedure, may avoid such complications associated with unrecognized lower urinary tract injuries.
References
Ulmsten U, Henriksson L, Johnson P, Varhos G (1996) An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J 7:81–85
Smith PP, Appell RA (2007) Transobturator tape, bladder perforation, and paravaginal defect: a case report. Int Urogynecol J Pelvic Floor Dysfunct 18:99–101
Starkman JS, Meints L, Scarpero HM, Dmochowski RR (2007) Vesicovaginal fistula following a transobturator midurethral sling procedure. Int Urogynecol J Pelvic Floor Dysfunct 18:113–115
Ashok K, Petri E (2012) Failures and complications in pelvic floor surgery. World J Urol 30:487–494
Danso D, Thein K, Haloob R (1998) Vesico-cutaneous fistula with a valvular stone: an unusual complication following gauze-hammock sling operation. J Obstet Gynaecol 133:292–294
Consent
Written informed consent of the patient was obtained before attempting to publish this paper
Conflicts of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Dokmeci, F., Yuce, T. & Cetinkaya, S.E. Vesico-cutaneous fistula: unusual complication after transobturator mid-urethral sling. Int Urogynecol J 25, 1437–1439 (2014). https://doi.org/10.1007/s00192-014-2374-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00192-014-2374-1