Transurethral Resection of Intravesical Mesh After Midurethral Sling Procedures

Abstract

Purpose:

We evaluated the efficacy of the transurethral resection (TUR) for the management of intravesically exposed polypropylene mesh after midurethral sling (MUS) procedures.

Patients and Methods:

Fourteen patients had a TUR for intravesical mesh after MUS procedures (tension-free vaginal tape, 11; transobturator tape, 3). In six patients with large stones, cystoscopic division and cystolitholapaxy were needed before the TUR.

Results:

Patients presented with dysuria (9), hematuria (7), urgency incontinence (5), urinary frequency (2), and pelvic pain (2). Thirteen of 14 (92.9%) patients had the mesh completely removed during a mean follow-up of 18 months; one patient had a recurrent bladder stone. Complications included de novo mixed incontinence, pelvic hematoma, and vesicovaginal fistula among three patients.

Conclusion:

Urologists should suspect intravesical mesh erosion or stone formation in patients with persistent pain, hematuria, or bladder irritation symptoms after MUS procedures. The TUR was a useful treatment modality for patients with intravesical complications after MUS procedures.