ABSTRACT
This chapter focuses on the complications associated with the most common surgeries for urinary incontinence, as well as those related to anterior vaginal wall prolapse surgery, which is often performed in the setting of incontinence surgery. Bladder injury may occur during dissection of the vaginal wall off the pubocervical fascia or during perforation of the endopelvic fascia into the retropubic space. Bleeding may occur during vaginal dissection, during perforation of the retropubic space, or during needle passage. Bleeding upon entry into the retropubic space can be difficult to manage, as exposure of the perivesical venous plexus is difficult. A Vesico-Vaginal Fistula (VVF) results from simultaneous injury to the bladder and vagina. The surgery most commonly associated with VVF is a transabdominal hysterectomy, followed by transvaginal hysterectomy. The most common cause of Uretero-Vaginal Fistula is total abdominal hysterectomy for either benign or malignant disease. Female incontinence and pelvic organ prolapse surgery has become a routine part of urologic care.
