Transvaginal repair of unrecognized bladder injury after transobturator tape surgery

Abstract

Currently, minimally invasive surgeries, which are often characterized by reliable and successful results, are preferred for the treatment of stress urinary incontinence. Although all of the currently used surgeries are minimally invasive, morbidities, including hemorrhage, voiding dysfunction, infection, pain, skin infection and erosion, and bladder injuries, are observed. We detected bladder injury in a 42-year-old female patient with complaints of burning and pain during urination who had previously undergone transobturator tape (TOT) surgery. Complete abdominal hysterectomy for a secondary myoma and a TOT procedure had been simultaneously performed 3 months prior to her presentation. Cystoscopy demonstrated a foreign body compatible with sling material in the bladder which was extracted transvaginally.

Bladder Injury: A complication of Transobturator Tape Surgery

“…They reported the incidence of bladder injury comparatively high during outside in technique than inside out technique. Complication of mesh eroding the bladder has also been reported in studies by Bayrak et al 1…”

“…Stress urinary incontinence (SUI) is an involuntary loss of urine especially seen in middle age parous women which develops as a result of activities like coughing, laughing, heavy weight lifting walking and running. 1 An estimated prevalence for urinary incontinence is nearly 30% in women aged 30-60 years, with approximately half of the cases attributed to SUI. 2 The initial treatment for SUI include lifestyle interventions, pelvic floor muscle training, and bladder training followed by surgery, which is an option for women whose quality of life is still impaired after a diagnosis of genuine stress incontinence has been confirmed.…”

“…3 Bladder injuries is one of the rarely reported challenging complications that might occur after TOT. 1…”