Holmium laser treatment of a vesical calculus secondary to TVT procedure

A case of vesical calculus is being presented as a complication of TVT procedure done for severe stress incontinence in an elderly lady. The patient, who presented with obstructive and irritative lower urinary tract symptoms, needed an indwelling catheter. Non-enhanced CT scan of abdomen confirmed an intraluminal calcific density in the anterior wall of urinary bladder just left of midline. On cystoscopy, a blue-colored polypropylene mesh of the TVT was visible at the ends of this calculus, holding it to the anterior vesical wall. Holmium laser was used to disintegrate the ends of the mesh deep in the submucosa of the urinary bladder. To our knowledge, this is a unique case of calculus forming near the dome of bladder over a TVT mesh presenting 3 years post-operatively and treated with holmium laser.