Abstract
The transobturator tape (TOT) procedure has become practically widespread worldwide. Complications seem to be rare, but recognizing them intraoperatively is the most significant step because some of the complications which may appear in postoperative period can be challenging for both physicians and patients. The purpose of this case, with this patient who was operated on with open surgery, is to evaluate this rarely seen unrecognized and uncommon bladder perforation after TOT procedure and thus make some contribution to the literature. Here, we present a case report about the treatment of a 48-year-old woman patient with unrecognized and uncommon bladder perforation after TOT procedure, 5 months postoperatively. Cystoscopic evaluation is not recommended routinely, but it must be performed if the patient is complicated enough to create doubt and also the surgeon's skill and ability are not sufficient enough to operate decently.
Highlights
Stress urinary incontinence (SUI), which has a major negative impact on the quality of life, is a widespread problem in women that will widely have operations in an effort to restore continence
We would like to share our experience of a patient with unusual and unrecognized bladder perforation and put emphasis on performing intraoperative cystoscopy to avoid such complications
This patient, a 48-year-old woman, was admitted to our clinic with complaints of dysuria, frequency, urge incontinence, and suprapubic and pelvic pain that continued for 5 months. She had a history of a previous transobturator tape (TOT) procedure for stress urinary incontinence performed at another hospital 5 months ago
Summary
Stress urinary incontinence (SUI), which has a major negative impact on the quality of life, is a widespread problem in women that will widely have operations in an effort to restore continence. Midurethral slings have gradually become the gold standard surgical treatment for female SUI over the last years [1]. These methods are not without complications, as in every surgical treatment. Bladder perforation is a troubled complication, which may lead to morbidity, if left unrecognized. In a meta-analysis of retropubic and transobturator midurethral slings, bladder perforation occurrence rate was reported to be 6.7% [2]. This is a significant rate and should be recognized in the surgery. We would like to share our experience of a patient with unusual and unrecognized bladder perforation and put emphasis on performing intraoperative cystoscopy to avoid such complications
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