BACKGROUND: Bowel perforation is a rare complication of tension-free vaginal tape (TVT)–type sling procedures and has been reported in patients with a previous history of abdominal or pelvic surgery.
CASE: A 77-year-old woman with no prior history of abdominal or pelvic surgery underwent elective surgery for pelvic organ prolapse with a vaginal vault colpocleisis and suburethral sling. On postoperative day 2, a computed tomography scan performed for suprapubic discomfort showed an enterocutaneous fistula, which was treated surgically.
CONCLUSION: Bowel perforation is a complication of TVT-type slings in patients with or without prior abdominal or pelvic surgery. High clinical suspicion, prompt identification, and surgical intervention allowed for a favorable outcome in this case.