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Bladder Perforation: A Missed Diagnosis Posttransobturator Tape
Vineet V Mishra1, Ruchika A Verneker1, Sunita Lamba1
1Department of Obstetrics and Gynaecology, Institute of Kidney Diseases and Research Centre, Ahmedabad, Gujarat, India.
Journal of Mid-Life Health
|January 30, 2019
Summary
Transobturator tape (TOT) surgery rarely causes bladder perforation. This case highlights a missed diagnosis for five years, emphasizing the need to rule out this complication in patients with persistent urinary symptoms after TOT.
Area of Science:
- Urology
- Gynecology
- Surgical Complications
Background:
- Transobturator tape (TOT) is a surgical procedure for stress urinary incontinence.
- While TOT has a lower risk of bladder perforation (1%) compared to tension-free vaginal tape (TVT) (5%), complications can still occur.
Observation:
- A case is presented where bladder perforation following TOT surgery was misdiagnosed for five years.
- The patient experienced recurrent dysuria and dyspareunia, initially treated as urinary tract infections.
Findings:
- Delayed diagnosis of bladder perforation associated with TOT can lead to prolonged patient suffering.
- Cystoscopic mesh excision successfully resolved the patient's symptoms.
Implications:
- Bladder perforation is a rare but significant complication of TOT surgery.
- Clinicians should consider bladder perforation in patients with persistent lower urinary tract symptoms or signs of surgical failure post-TOT, even years after the procedure.
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