Residual Pelvic Mesh Mimicking Bladder Calculus With Diagnostic Imaging: A Case Study

Abstract

Surgical pelvic mesh is a net-like material used to support weakened pelvic muscle walls and the urethra or urinary bladder. It is used to treat symptomatic pelvic organ prolapse (POP) and stress urinary incontinence (SUI), among female patients. However, its use has become controversial due to higher relapse rates and mesh-related complications. Moreover, removing the mesh as a whole may not be possible, and the symptoms may persist. Several surgical pelvic mesh techniques are available; familiarity with these techniques, along with knowledge of normal and abnormal appearances, is necessary to successfully complete diagnostic imaging for these patients. This case report presents a female patient who had undergone revision surgery for retrieval of surgical pelvic mesh implanted for POP. The patient was unaware of its incomplete removal. The patient presented with urinary complaints and was initially diagnosed with a urinary bladder calculus on sonography, due to the lack of disclosed surgical history. During the pre-operative diagnostics for calculus removal, cystoscopy revealed encrusted soft tissue, which was found to be residual mesh and sutures in the urinary bladder wall. This case highlights the importance of a comprehensive clinical and diagnostic imaging history, along with a review of previous operative notes, to provide a complete evaluation of these patients.