Cecal perforation complicating placement of a transvaginal tension-free vaginal tape

The tension-free vaginal tape has been increasingly used to treat stress urinary incontinence. This procedure has a high success rate and unique surgical complications. The patient is a 39-year-old with genuine stress urinary incontinence and underwent placement of tension-free vaginal tape for treatment. Twelve hours after the procedure, the patient had increasing abdominal pain, and an acute abdominal series showed free intraperitoneal air. Exploratory laparotomy revealed stool in the peritoneal cavity, with the vaginal tape placed through the cecum. Bowel complications are rare; however, they may occur and should be suspected in a patient with an acute abdomen and free air.