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Transurethral resection of intravesical mesh after midurethral sling procedures

Tae-Hee Oh1, Dong-Soo Ryu

  • 1Department of Urology, Masan Samsung Hospital, Sungkyunkwan University School of Medicine, Masan, Korea.

Journal of Endourology
|July 14, 2009
PubMed
Abstract

Insights

Transurethral resection effectively manages intravesical mesh complications after midurethral sling procedures. This TUR treatment removed mesh in 92.9% of patients, resolving symptoms like pain and hematuria.

Area of Science:

  • Urology
  • Gynecologic Surgery
  • Medical Device Complications

Background:

  • Midurethral sling (MUS) procedures are common for stress urinary incontinence.
  • Intravesical mesh exposure is a known complication of MUS, potentially leading to stones and symptoms.
  • Management options for intravesical mesh erosion require evaluation.

Purpose of the Study:

  • To assess the efficacy of transurethral resection (TUR) for managing intravesical polypropylene mesh.
  • To evaluate TUR as a treatment for complications arising after midurethral sling (MUS) surgery.

Main Methods:

  • A cohort of 14 patients undergoing TUR for intravesical mesh post-MUS were analyzed.
  • Procedures included TUR, with cystoscopic division and cystolitholapaxy for six patients with stones.
  • Follow-up data on mesh removal, symptom resolution, and complications were collected.

Main Results:

  • Transurethral resection (TUR) achieved complete mesh removal in 13 of 14 (92.9%) patients.
  • Common presenting symptoms included dysuria, hematuria, urgency incontinence, and pelvic pain.
  • Complications occurred in three patients, including de novo incontinence, hematoma, and fistula.

Conclusions:

  • Transurethral resection (TUR) is an effective treatment for intravesical mesh complications after midurethral sling (MUS) procedures.
  • Persistent urinary symptoms post-MUS should prompt suspicion of mesh erosion or stone formation.
  • Urologists should consider TUR for managing these intravesical mesh-related issues.

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