Abstract
Bowel perforation is a rare complication of mid-urethral sling procedures and is usually reported shortly after the surgery. We report a remotely discovered asymptomatic bowel injury found at the time of subsequent surgery. The patient with a history of several prior pelvic surgeries underwent an uneventful retropubic mid-urethral sling placement. Five years later, during an abdominal sacrocolpopexy procedure, mesh from the mid-urethral sling was found perforating the wall of the cecum and fixating it to the right pelvic sidewall. Cecal wedge resection was performed to excise the sling mesh. Asymptomatic bowel perforation by mid-urethral sling mesh has not been previously reported. Pelvic and abdominal surgeons should be aware of the possibility of finding this injury in patients with prior sling surgeries.
Abbreviations
- BMI:
-
Body mass index
- CT:
-
Computed tomography
- GIA:
-
Gastrointestinal anastomosis
- TVT:
-
Tension-free vaginal tape
References
Ulmsten U, Petros P (1995) Intravaginal slingplasty (IVS): an ambulatory surgical procedure for treatment of female urinary incontinence. Scand J Urol Nephrol 29(1):75–82
Kuuva N, Nilsson CG (2002) A nationwide analysis of complications associated with the tension-free vaginal tape (TVT) procedure. Acta Obstet Gynecol Scand 81(1):72–77
Agostini A, Bretelle F, Franchi F, Roger V, Cravello L, Blanc B (2006) Immediate complications of tension-free vaginal tape (TVT): results of a French survey. Eur J Obstet Gynecol Reprod Biol 124(2):237–239
Phillips L, Flood CG, Schulz JA (2009) Case report of tension-free vaginal tape-associated bowel obstruction and relationship to body habitus. Int Urogynecol J Pelvic Floor Dysfunct 20(3):367–368
Gruber DD, Wiersma DS, Dunn JS, Meldrum KA, Krivak TC (2007) Cecal perforation complicating placement of a transvaginal tension-free vaginal tape. Int Urogynecol J Pelvic Floor Dysfunct 18(6):671–673
Rooney KE, Cholhan HJ (2010) Bowel perforation during retropubic sling procedure. Obstet Gynecol 115(2 Pt 2):429–431
Huffaker RK, Yandell PM, Shull BL (2010) Tension-free vaginal tape bowel perforation. Int Urogynecol J Pelvic Floor Dysfunct 21(2):251–253
Meschia M, Busacca M, Pifarotti P, De Marinis S (2002) Bowel perforation during insertion of tension-free vaginal tape (TVT). Int Urogynecol J Pelvic Floor Dysfunct 13(4):263–265, discussion 5
Leboeuf L, Mendez LE, Gousse AE (2004) Small bowel obstruction associated with tension-free vaginal tape. Urology 63(6):1182–1184
Castillo OA, Bodden E, Olivares RA, Urena RD (2004) Intestinal perforation: an infrequent complication during insertion of tension-free vaginal tape. J Urol 172(4 Pt 1):1364
Fourie T, Cohen PL (2003) Delayed bowel erosion by tension-free vaginal tape (TVT). Int Urogynecol J Pelvic Floor Dysfunct 14(5):362–364
Gurshumov EL, Klapper AS, Sierecki AR (2010) Small bowel perforation in a hernia sac after TVT placement at the time of colpocleisis. Int Urogynecol J Pelvic Floor Dysfunct 21(3):371–373
Acknowledgments
The authors gratefully acknowledge the photographic assistance of Crystal Berthelette.
Conflicts of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Elliott, J.E., Maslow, K.D. Remote discovery of an asymptomatic bowel perforation by a mid-urethral sling. Int Urogynecol J 23, 243–245 (2012). https://doi.org/10.1007/s00192-011-1510-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00192-011-1510-4