Philippe Grange1, Chryssanthos Kouriefs2, Fanourios Georgiades3, Stavros Charalambous4, Dudley Robinson1, Linda Cardozo1. 1. King's College Hospital, London, United Kingdom. 2. Urology Department, Ygia Polyclinic Private Hospital, Limassol, Cyprus. Electronic address: ckouriefs@hotmail.com. 3. Urology Department, Ygia Polyclinic Private Hospital, Limassol, Cyprus; St Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom. 4. Urology Department, Ygia Polyclinic Private Hospital, Limassol, Cyprus.
Abstract
OBJECTIVE: To report our experience on vesicoscopic excision of eroded foreign material in the bladder. MATERIALS AND METHODS: The use of xenografts in female urology is becoming more prevalent and so are their complications. Erosion of foreign material into the bladder often goes unrecognized for a long time and patients are troubled by irritative urinary symptoms, recurrent infections, and stone formation. The treatment of such erosions is traditionally reported through the transurethral route using laser or electrocautery to cut the foreign material. Such methods have a high rate of incomplete material removal and as a result a high recurrence rate. Leaving a urothelial defect results in prolonged time to symptom resolution. Between 2012 and 2015, 5 patients with eroded tapes were referred for tertiary care to King's College Hospital and Ygia Polyclinic; all patients had undergone a variety of endoscopic, vaginal, and/or open attempts for mesh removal that failed. We offered vesicoscopic excision of the eroded portion of the tape. RESULTS: We here report 5 cases with tape erosions referred to our team that were treated with vesicoscopic excision of the material and primary closure of the urothelial defect. The foreign material was completely removed in all cases and there is no recurrence at a median follow-up of 30 months. CONCLUSION: Vesicoscopic excision of bladder-eroded foreign material is feasible and efficient. We recommend this technique to be considered as a primary approach to tapes eroding into the bladder.
OBJECTIVE: To report our experience on vesicoscopic excision of eroded foreign material in the bladder. MATERIALS AND METHODS: The use of xenografts in female urology is becoming more prevalent and so are their complications. Erosion of foreign material into the bladder often goes unrecognized for a long time and patients are troubled by irritative urinary symptoms, recurrent infections, and stone formation. The treatment of such erosions is traditionally reported through the transurethral route using laser or electrocautery to cut the foreign material. Such methods have a high rate of incomplete material removal and as a result a high recurrence rate. Leaving a urothelial defect results in prolonged time to symptom resolution. Between 2012 and 2015, 5 patients with eroded tapes were referred for tertiary care to King's College Hospital and Ygia Polyclinic; all patients had undergone a variety of endoscopic, vaginal, and/or open attempts for mesh removal that failed. We offered vesicoscopic excision of the eroded portion of the tape. RESULTS: We here report 5 cases with tape erosions referred to our team that were treated with vesicoscopic excision of the material and primary closure of the urothelial defect. The foreign material was completely removed in all cases and there is no recurrence at a median follow-up of 30 months. CONCLUSION: Vesicoscopic excision of bladder-eroded foreign material is feasible and efficient. We recommend this technique to be considered as a primary approach to tapes eroding into the bladder.