Delayed Presentation of Cecal Perforation With Tension-Free Vaginal Tape

Mayhew, Allison; Ford, Alexcis T; Northington, Gina M.; Shaffer, Virginia; Kelley, Robert S.

doi:10.1097/aog.0000000000002495

Cited by 4 publications

(4 citation statements)

References 17 publications

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“…Our patient had none of the general symptoms described above. But she mainly had a local suprapubic skin infection, similar to the case reported in the literature [11], which occurred 7 years after surgery. In our case, the sigmoid colon perforation occurred during the surgery.…”

Section: Discussionsupporting

confidence: 80%

“…Bowel injuries have rarely been reported in the literature, with most reported cases involving the small intestine becoming clinically apparent in perioperative period after the procedure [5,6]. In some cases, bowel perforations may be found very late ranging from several months to years [7][8][9], especially in cecum [10] and sigmoid colon [11], which is very similar to what was found in our case but that occurred 7 years after surgery. We recently experienced a case of sigmoid colon perforation and colocutaneous fistula 2 weeks after the TVT tape procedure was performed.…”

Section: Introductionsupporting

confidence: 85%

“…Bowel injuries involving the small intestine usually have acute symptoms such as fever, nausea, vomiting, abdominal pain, distention and diminished bowel sounds because of peritonitis and bowel obstruction and can be diagnosed early [5,6]. Whereas bowel injuries involving colon [10,11], it may be found very late ranging from several months to years. Our patient had none of the general symptoms described above.…”

Section: Discussionmentioning

confidence: 99%

“…Colonoscopy is needed to verify the suspicion. After bowel injury is confirmed, an open or laparoscopic exploratory laparotomy [11] with excision of the mesh and repair of the bowel should be performed promptly.…”

Section: Discussionmentioning

confidence: 99%

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Case report of sigmoid colon perforation and colocutaneous fistula due to retropubic midurethral sling placement for stress urinary incontinence

2020

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Background: Sigmoid bowel perforation is a very rare and serious complication of the retropubic tension-free vaginal tape (TVT) procedure for female stress urinary incontinence. The complication can be avoided with the use of the correct manipulation technique. Case presentation: A 75-year-old female patient underwent a retropubic TVT procedure in the local hospital for the treatment of stress urinary incontinence. The procedure was smooth. Two weeks after surgery, the patient began to complain of fever and bloody, purulent discharge from the left suprapubic skin wound. During a 4-month period after surgery, she was admitted to the local hospital 4 times for similar infection symptoms. The infections were temporarily controlled with antibiotic administration. The reason for the refractory infection of the left suprapubic skin wound was not identified until a foreign TVT mesh was found in the sigmoid colon via a colonoscopy. We diagnosed that the TVT mesh caused a sigmoid colon perforation that led to colocutaneous fistula. An exploratory laparotomy revealed that the TVT tape perforated into and out of the sigmoid colon. An 8-cm long left part of mesh was removed. Two ruptures of sigmoid colon were mended without the need for bowel resection. At the 4-years follow-up after laparotomy, the patient was doing well and still continent. Conclusions: Urologists and gynecologists should be aware of the possibility of colon bowel injury in SUI patients with prior sling surgeries. Patient having recurrent suprapubic cutaneous infection may have high degree of suspicion of colon injury after TVT sling. The passage of the retropubic space procedure should be slow and always along the pubic bone according to the anatomy.

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Section: Discussionsupporting

confidence: 80%