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Misplaced Macroplastique injection presenting as a vaginal nodule and a bladder mass
S Kulkarni1, A J W Davies, K Treurnicht
1Urology Department, 11th Floor, Royal Free Hospital, Pond St, NW3 2QG London, UK . kulkarnishailesh@hotmail.com
Summary
Misplaced Macroplastique injection, a synthetic material used in pelvic floor repairs, can unexpectedly appear as bladder lesions and vaginal nodules. This finding was incidentally discovered during tension-free vaginal tape surgery.
Area of Science:
- Urogynecology
- Medical Device Complications
- Surgical Pathology
Background:
- Tension-free vaginal tape (TVT) surgery is a common procedure for treating female stress urinary incontinence.
- Macroplastique is a widely used synthetic material for pelvic floor reconstruction.
- Accurate placement and potential migration of surgical materials are critical considerations.
Observation:
- An unusual case of misplaced Macroplastique injection material was identified.
- The misplaced material presented as a bladder lesion and a vaginal nodule.
- These findings were incidentally discovered during a separate tension-free vaginal tape procedure.
Findings:
- The misplaced Macroplastique material caused unexpected anatomical changes, manifesting as a bladder lesion and vaginal nodule.
- This case highlights the potential for delayed or incidental detection of misplaced surgical implants.
- Histopathological examination confirmed the presence of synthetic material.
Implications:
- This case underscores the importance of meticulous surgical technique and awareness of potential implant migration.
- Enhanced imaging or intraoperative assessment may be considered in cases with suspected material displacement.
- Clinicians should be vigilant for atypical presentations of pelvic floor repair materials, even years after implantation.