Abstract

Introduction The Tension-free Vaginal Tape (TVT) is the most commonly performed procedure for the management of Stress Urinary Incontinence (SUI). There is insufficient data on the occurrence of complications and their management. The incidence of tape erosion and infection is observed to be higher with synthetic non-absorbable slings. Case A 50-year-old parous lady with multiple co-morbidities underwent the TVT procedure and no urinary bladder perforation was noted on routine check cystoscopy intraoperatively. She complained of persistent vaginal discharge, urinary frequency and urgency with nocturia, vaginal pain and dysuria from one month postoperatively. Examination findings were normal and she was prescribed tolterodine for overactive bladder symptoms and advised diabetes control. One year and seven months postoperatively, the patient was referred by the polyclinic to a urology clinic in view of incidental CT (Computed Tomography) scan findings of thickening with calcification in the left lateral aspect of her urinary bladder. A diagnostic cystoscopy revealed tape erosion into the bladder. A few days later, she had gross hematuria. She underwent an open partial cystectomy and the eroded mesh and the adjacent parts of the bladder wall were excised and the bladder was repaired. Result She recovered well postoperatively and there was no recurrence of SUI. Conclusions Bladder erosion is a rare complication of TVT but should be suspected in a patient who presents with disproportional vaginal pain or hematuria. There should be a low threshold for diagnostic cystoscopy in women who have undergone previous TVT.

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