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A complex fistula caused by an eroding pelvic mesh sling.

Ugo Ihedioha¹, E Leung, L Chung

¹Professorial Unit of Surgery, Western Infirmary, Glasgow, G11 6NT, UK. ugoihedioha@hotmail.com

Hernia : the Journal of Hernias and Abdominal Wall Surgery

|October 7, 2006

Summary

Pelvic mesh slings, used for abdomino-pelvic partitions, can erode into the small bowel, causing fistulas. Surgical intervention including mesh removal is necessary to treat this rare complication.

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Area of Science:

Urology
Gastroenterology
Surgical Oncology

Background:

Abdomino-pelvic partitions using pelvic mesh slings are common surgical procedures.
These procedures are generally considered safe with low complication rates.

Observation:

A 60-year-old male, post-rectal cancer resection and radiotherapy, developed an entero-vesicle-cutaneous fistula.
The fistula resulted from polypropylene mesh erosion into the small bowel.

Findings:

The patient required total cystectomy, small bowel resection, and mesh removal.
This surgical intervention successfully alleviated the fistula symptoms.

Implications:

This case highlights a rare but serious complication of pelvic mesh sling use.

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It underscores the importance of considering mesh complications in patients with prior pelvic surgery and radiotherapy.