Delayed bowel erosion by tension-free vaginal tape (TVT).
A 71-year-old woman who had had a previous abdominal hysterectomy and Burch operation presented with stress urinary incontinence due to intrinsic urethral sphincter deficiency. She underwent a technically difficult placement of a TVT tape in April 2002. After an uneventful recovery she was discharged after 72 hours but presented almost 5 months later with small bowel obstruction. At laparotomy she had a loop of ileum adherent to the left lower side wall of the pelvis, with the TVT tape penetrating and traversing this loop. The ileal segment was excised and an end-to-end anastomosis performed. Her recovery was uneventful and she is maintaining her urinary continence. Patients who have had previous combined pelvic intra- and extraperitoneal surgery should be operated on by experienced surgeons and be observed for 24 hours. The placement of a Uratape (Porges-Mentor) via a transobturator approach should also be considered in such cases.
Fourie
T
T
Department of Urology, University of Natal, Durban, South Africa. fouriet@nu.ac.za
Cohen
P L
PL
D000368:Aged; D005260:Female; D006801:Humans; D007082:Ileum / Q000293:injuries* / Q000601:surgery; D007415:Intestinal Obstruction / Q000209:etiology* / Q000601:surgery; D007416:Intestinal Perforation / Q000209:etiology* / Q000601:surgery; D019736:Prostheses and Implants / Q000009:adverse effects*; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014621:Vagina / Q000601:surgery*