Delayed presentation of an enterocutaneous fistula after tension-free vaginal tape sling

Lauren B. Westermann, Anitra Brown, Jaime Long

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Background: Bowel injury is a rare but serious complication associated with tension-free vaginal tape (TVT) sling procedures. Case: A 50-year-old woman with a previous history of pelvic surgery underwent TVT for stress urinary incontinence. Surgery and the immediate postoperative period were unremarkable; however, she returned 5 months later with bloody, purulent discharge from a suprapubic exit site. This was unresponsive to antibiotic therapy, and when the patient returned with abdominal pain and fever, a computed tomographic scan showed an enterocutaneous fistula. At the time of exploratory laparotomy, the mesh was noted to have perforated the small bowel and led to a sinus tract that communicated with the skin. Conclusions: Bowel perforation is a recognized, but rare, complication of TVT. This case highlights the need for a high index of suspicion for bowel injury after TVT maintained beyond the more commonly described peritonitis or obstructive symptoms presenting in the immediate perioperative period.

Original languageEnglish (US)
Pages (from-to)258-259
Number of pages2
JournalFemale Pelvic Medicine and Reconstructive Surgery
Volume17
Issue number5
DOIs
StatePublished - Jan 1 2011

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All Science Journal Classification (ASJC) codes

  • Surgery
  • Obstetrics and Gynecology
  • Urology

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