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Delayed Presentation of Cecal Perforation With Tension-Free Vaginal Tape

Mayhew, Allison, C., MD; Ford, Alexcis, T., MD; Northington, Gina, M., MD, PhD; Shaffer, Virginia, O., MD; Kelley, Robert, S., DO

doi: 10.1097/AOG.0000000000002495
Contents: Female Pelvic Reconstruction: Case Report

BACKGROUND: Tension-free vaginal tape (TVT) is a popular operative treatment for stress urinary incontinence (SUI). It has a low risk of adverse events, and injuries, particularly to the bowel, are rare. Case reports that have previously discussed these injuries and subsequent removal of TVT have not provided additional insight into management of SUI after these injuries occur.

CASE: A postmenopausal woman with persistent SUI presented more than 1 year after TVT placement with bowel perforation incidentally discovered on routine screening colonoscopy. She underwent removal of the TVT and subsequent placement of a fascial sling with postoperative resolution of SUI.

CONCLUSION: This case provides additional evidence for bowel injury as a postoperative TVT complication and describes an approach to complicated TVT and persistent SUI.

Fascial slings remain a reliable option for the treatment of stress urinary incontinence, particularly after tension-free vaginal tape complication or failure.

Departments of Gynecology and Obstetrics and Surgery, Emory University School of Medicine, Atlanta, Georgia.

Corresponding author: Robert S. Kelley, DO, Department of Gynecology and Obstetrics, Division of Female Pelvic Medicine and Reconstructive Surgery, Emory University School of Medicine, Building A, 4th Floor, Room A4251, 1365 Clifton Road NE, Atlanta, GA 30322; email: robert.kelley@emory.edu.

Financial Disclosure The authors did not report any potential conflicts of interest.

The authors thank Don W. Roberts, MD, President of Tifton Endoscopy Center, for contributing colonoscopy images.

Each author has indicated that he or she has met the journal's requirements for authorship.

© 2018 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.