Related Experiment Video
Updated: Jan 5, 2026
A Novel Surgical Technique in a Sheep Model for Suburethral Graft Implantation
Published on: June 20, 2025
A novel combined transurethral and suprapubic approach for excision of mesh at the bladder neck
Gabriel N Schaer1, Tilmann Moeltgen2, Gloria Ryu3
1Department of Obstetrics and Gynecology, Kantonsspital Aarau, 5001, Aarau, Switzerland. gabriel.schaer@ksa.ch.
Introduction And Hypothesis:
Unrecognized bladder perforation of a tension-free sling is a rare situation. Removal of the intravesical sling has been done by laparotomy or transurethrally. With technique presented here we want to show a minimally invasive approach that allows complete removal of the intraluminal sling material, located at the bladder neck.
Methods:
This video shows a novel combined transurethral and suprapubic approach for radical removal of the mesh. Two 3.5-mm trocars were placed suprapubically into a filled bladder. One site was used for an optic with camera and the other for a 3.5-mm grasping forceps to apply tension on the mesh to pull it out of the bladder wall while it was being excised transurethrally with a cystoscope and transurethral scissors.
Results:
The patient's postoperative course was uneventful. At 1-month follow-up, the patient was free of dysuria and cystoscopy revealed complete healing of the mesh site. Because of recurrent stress urinary incontinence, another continence sling surgery has been performed (TVT exact). After a follow-up of 2 years, she is continent and free of dysuria.
Conclusions:
This novel technique provides an effective means of removing mesh perforated into the bladder, located at the bladder neck, using a combined transurethral and suprapubic approach. The technique is minimally invasive and the applied traction allows complete removal of the intraluminal part of the mesh.
