Bladder injury during transobturator sling.
The new minimally invasive transobturator sling for surgical treatment of female genuine stress urinary incontinence is designed to reproduce the natural suspension of the urethral fascia while eliminating the need for retropubic needle passage. We report 3 cases of bladder perforation during the transobturator sling procedure. All injuries were identified intraoperatively by cystoscopy, and successful reinsertion of the mesh was accomplished. Transurethral bladder drainage with a Foley catheter was maintained for 5 to 7 days postoperatively. All 3 patients recovered uneventfully. Routine intraoperative cystoscopy is, therefore, recommended for the identification of bladder injuries during the transobturator sling procedure.
Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Southern California Keck School of Medicine, Los Angeles, California, USA.
Steven
S
Minaglia
Begüm
B
Ozel
Carl
C
Klutke
Charles
C
Ballard
John
J
Klutke
D003558:Cystoscopy; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D007431:Intraoperative Complications / Q000175:diagnosis / Q000209:etiology*; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D013526:Surgical Mesh; D001743:Urinary Bladder / Q000293:injuries*; D014550:Urinary Incontinence, Stress / Q000150:complications / Q000601:surgery*