Tae-Hee Oh1, Dong-Soo Ryu. 1. Department of Urology, Masan Samsung Hospital, Sungkyunkwan University School of Medicine, Masan, Korea.
Abstract
PURPOSE: We evaluated the efficacy of the transurethral resection (TUR) for the management of intravesically exposed polypropylene mesh after midurethral sling (MUS) procedures. PATIENTS AND METHODS: Fourteen patients had a TUR for intravesical mesh after MUS procedures (tension-free vaginal tape, 11; transobturator tape, 3). In six patients with large stones, cystoscopic division and cystolitholapaxy were needed before the TUR. RESULTS: Patients presented with dysuria (9), hematuria (7), urgency incontinence (5), urinary frequency (2), and pelvic pain (2). Thirteen of 14 (92.9%) patients had the mesh completely removed during a mean follow-up of 18 months; one patient had a recurrent bladder stone. Complications included de novo mixed incontinence, pelvic hematoma, and vesicovaginal fistula among three patients. CONCLUSION: Urologists should suspect intravesical mesh erosion or stone formation in patients with persistent pain, hematuria, or bladder irritation symptoms after MUS procedures. The TUR was a useful treatment modality for patients with intravesical complications after MUS procedures.
PURPOSE: We evaluated the efficacy of the transurethral resection (TUR) for the management of intravesically exposed polypropylene mesh after midurethral sling (MUS) procedures. PATIENTS AND METHODS: Fourteen patients had a TUR for intravesical mesh after MUS procedures (tension-free vaginal tape, 11; transobturator tape, 3). In six patients with large stones, cystoscopic division and cystolitholapaxy were needed before the TUR. RESULTS:Patients presented with dysuria (9), hematuria (7), urgency incontinence (5), urinary frequency (2), and pelvic pain (2). Thirteen of 14 (92.9%) patients had the mesh completely removed during a mean follow-up of 18 months; one patient had a recurrent bladder stone. Complications included de novo mixed incontinence, pelvic hematoma, and vesicovaginal fistula among three patients. CONCLUSION: Urologists should suspect intravesical mesh erosion or stone formation in patients with persistent pain, hematuria, or bladder irritation symptoms after MUS procedures. The TUR was a useful treatment modality for patients with intravesical complications after MUS procedures.
Authors: Jerry G Blaivas; Rajveer S Purohit; Matthew S Benedon; Gabriel Mekel; Michael Stern; Mubashir Billah; Kola Olugbade; Robert Bendavid; Vladimir Iakovlev Journal: Nat Rev Urol Date: 2015-08-18 Impact factor: 14.432