Bladder injury during trans-obturator tape surgery in a patient with previous colposuspension: is there a connection?

Bladder injuries are quite rare and complex complications of transobturator tapes in the treatment of female stress urinary incontinence, with very few published cases. The authors present a case report and discuss possible injury mechanisms and the role of cystoscopy in this setting.

A 51 year-old female with past surgical history of Burch colposuspension underwent an uneventful transobturator tape surgery. After 15 days, she complained of dysuria and frequency. Cystoscopy revealed the tape protruding within the bladder.

Reoperation was performed with the sub-urethral segment of the tape removed by vaginal approach and the vesical one excised endoscopically. Presently, the patient is asymptomatic.

In patients with previous incontinence surgical treatments, cystoscopy at the time of surgery should be considered to exclude and treat eventual injuries, in order to avoid future complications.