Sigmoid bowel perforation is a very rare and serious complication of the retropubic tension-free vaginal tape (TVT) procedure for female stress urinary incontinence. The complication can be avoided with the use of the correct manipulation technique. A 75-year-old female patient underwent a retropubic TVT procedure in the local hospital for the treatment of stress urinary incontinence. The procedure was smooth. Two weeks after surgery, the patient began to complain of fever and bloody, purulent discharge from the left suprapubic skin wound. During a 4-month period after surgery, she was admitted to the local hospital 4 times for similar infection symptoms. The infections were temporarily controlled with antibiotic administration. The reason for the refractory infection of the left suprapubic skin wound was not identified until a foreign TVT mesh was found in the sigmoid colon via a colonoscopy. We diagnosed that the TVT mesh caused a sigmoid colon perforation that led to colocutaneous fistula. An exploratory laparotomy revealed that the TVT tape perforated into and out of the sigmoid colon. An 8-cm long left part of mesh was removed. Two ruptures of sigmoid colon were mended without the need for bowel resection. At the 4-years follow-up after laparotomy, the patient was doing well and still continent. Urologists and gynecologists should be aware of the possibility of colon bowel injury in SUI patients with prior sling surgeries. Patient having recurrent suprapubic cutaneous infection may have high degree of suspicion of colon injury after TVT sling. The passage of the retropubic space procedure should be slow and always along the pubic bone according to the anatomy.

中文翻译：

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耻骨后中尿道吊带放置乙状结肠穿孔和结肠镜瘘治疗压力性尿失禁的病例报告

乙状结肠穿孔是女性压力性尿失禁的耻骨后无张力阴道带（TVT）手术的一种非常罕见且严重的并发症。使用正确的操作技术可以避免并发症。一名75岁的女性患者在当地医院进行了耻骨后TVT手术，以治疗压力性尿失禁。程序很顺利。手术两周后，患者开始抱怨发烧，血流，耻骨上皮左伤口脓性分泌物。在手术后的四个月中，她因类似的感染症状被四次送往当地医院。感染可通过抗生素管理暂时控制。直到通过结肠镜检查在乙状结肠中发现异物TVT网片后，才能确定左耻骨上皮肤伤口难治性感染的原因。我们诊断出TVT网孔造成了乙状结肠穿孔，从而导致了结肠皮肤瘘。探索性剖腹手术显示TVT胶带穿入乙状结肠和穿出乙状结肠。除去网眼的一个8厘米长的左侧部分。修补了两次乙状结肠破裂，无需肠切除。在剖腹手术后的4年随访中，患者情况良好，并且仍然处于大陆状态。泌尿科医师和妇科医师应意识到在先前进行过吊带手术的SUI患者中结肠肠损伤的可能性。反复耻骨上皮肤感染的患者可能会对TVT吊带后的结肠损伤有高度怀疑。