The injury of bladder without penetrate during the TVT surgery for stress incontinence

Summary

Objective:
The aim of this article is alert to possibile of non-penetrating injury of bladder and risk of extraperitoneal bleeding during the TVT surgery when the tape is inserted by retropubic path. This type of injury can´t be find by cystoscopy and there can be a serious blood loss in to the interstitial space. According this fact, there is a great importance of this injury and there is an urgent need to prompt reaction on this situation. In this way, we do prevent serious risk of health damage.

Design:
Case report.

Setting:
Department of Obstetrics and Gynaecology, 3rd Faculty of Medicine, Charles University, Faculty Hospital Královské Vinohrady, Prague.

Methods:
The different authors presents various percentage of complications in the case of TVT surgery. The differences follow from size of patient´s group, type of surgical procedure, type of the tape and the way of tape insertion. Nevertheless, differences between these results are statistically nonsignificant.

Conclusions:
The operation´s complications and early after operation´s complications can arise in the course of any surgery and iatrogenic complications also belong to this group. Minimally invasive surgery is certainly make not an exception. The most often signs of these complications are abdominal pain, presence of blood in urine, anemia, malfunction of bladder and possible breakdown of intestinal activity. If the conservative methods failed, we have to perform operating inspection. The cooperation with surgeon or urologist is certainly needed.

Keywords:
incontinency – TVT – retropubic haematoma – operating injury