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477
Vaginal and laparoscopic sub-urethral sling explantation
Virginie Collin-Bund1,2, Victor Gabriele3, Chris Minella3
1Department of Gynecologic Surgery, Hôpitaux Universitaires de Strasbourg, 67091, Strasbourg, France. virginie.bund@chru-strasbourg.fr.
International Urogynecology Journal
|March 11, 2023
Summary
This study details laparoscopic and vaginal removal of infected sub-urethral slings. It highlights managing unusual complications like calcification and advises antibiotic use to prevent infection after mesh surgery.
Area of Science:
- Urogynecology
- Minimally Invasive Surgery
- Surgical Complications
Background:
- Sub-urethral slings are used for stress urinary incontinence.
- Infection and pain are potential complications requiring mesh explantation.
- Previous surgeries may complicate explantation procedures.
Purpose of the Study:
- To describe laparoscopic and vaginal techniques for infected sub-urethral mesh explantation.
- To report an unusual complication of sub-mucosal calcification of the sling.
- To provide guidance for managing complex mesh removal cases.
Main Methods:
- Laparoscopic approach to the space of Retzius for infected retropubic sling removal.
- Vaginal surgical steps for explantation.
- Management of a case with prior unsuccessful surgeries.
Main Results:
- Successful complete removal of an infected retropubic sling was achieved laparoscopically.
- An unusual sub-mucosal calcification on the sling, not infiltrating the urethra, was identified.
- The case involved a patient with a history of three prior surgeries for unresolved symptoms.
Conclusions:
- Laparoscopic and vaginal techniques are crucial for infected mesh explantation.
- Awareness of potential complications like calcification is important.
- Multidisciplinary discussion and management in expert centers are recommended for complex cases.
