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Bladder perforation presenting as vulvar edema after the tension-free vaginal tape procedure. A case report
Ling-Hong Tseng1, Tsia-Shu Lo, Alex C Wang
1Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan, R.O.C.
Background:
Bladder perforation during the tension-free vaginal tape (TVT) procedure is a common complication.
Case:
Vulvar edema was noted 4 hours after application of TVT, and cystoscopy revealed bladder perforation. The patient had a history of a previous vaginal hysterectomy with anterior colporrhaphy.
Conclusion:
To our knowledge, this is the first case report of vulvar edema following TVT. Bladder filling to 250 mL, 70 degrees cystoscopy, good skills in cystoscopy and familiarity with retropubic anatomy are key issues for the TVT procedure. A cystoscopic examination before the TVT procedure should be considered for patients with previous pelvic surgery.
