Late Bladder Erosion Complications and Vesical Stone Formations of Synthetic Graft Materials Used in Mid-Urethral Sling Procedures

E. Okulu, K. Ener, M. Aldemir, Ö. Kayıgil
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Abstract

We present a case of 2 patients with late bladder erosion and vesical stone formation due to mesh erosion from mid-urethral polypropylene slings and their management. Patients presented 18 and 22 months after surgery with hematuria, recurrent urinary tract infections, and lower urinary tract symptoms. Stone fragmentation was done by pneumatic lithotripsy, and transurethral resection of the mesh was performed using a 26 Fr resectoscope. Postoperative control cystoscopy demonstrated complete healing of bladder mucosa after 3 months. The patients were satisfied with this result, and the patients reported significant improvement of symptoms. The patients remained completely continent at the follow-up period. The endoscopic management of the eroded mesh should be the first choice of bladder erosion therapy. Careful and comprehensive urethrocystoscopy is mandatory during a mid-urethral sling procedure. There is a need for long-term follow-up of patients with mid-urethral slings. We present a case of 2 patients with late bladder erosion and vesical stone formation due to mesh erosion from mid-urethral polypropylene slings and their management. Patients presented 18 and 22 months after surgery with hematuria, recurrent urinary tract infections, and lower urinary tract symptoms. Stone fragmentation was done by pneumatic lithotripsy, and transurethral resection of the mesh was performed using a 26 Fr resectoscope. Postoperative control cystoscopy demonstrated complete healing of bladder mucosa after 3 months. The patients were satisfied with this result, and the patients reported significant improvement of symptoms. The patients remained completely continent at the follow-up period. The endoscopic management of the eroded mesh should be the first choice of bladder erosion therapy. Careful and comprehensive urethrocystoscopy is mandatory during a mid-urethral sling procedure. There is a need for long-term follow-up of patients with mid-urethral slings.
在中尿道悬吊手术中使用合成移植材料的晚期膀胱糜烂并发症和膀胱结石形成
我们报告2例晚期膀胱糜烂及膀胱结石形成的病例,原因是尿道中部聚丙烯吊带造成的网状物糜烂及处理。患者术后18至22个月出现血尿、复发性尿路感染和下尿路症状。采用气压碎石法粉碎结石,并采用26 Fr切除镜经尿道切除网状物。术后对照膀胱镜检查显示3个月后膀胱黏膜完全愈合。患者对这个结果感到满意,并且患者报告症状明显改善。在随访期间,患者保持完全自主。内窥镜下处理糜烂的补片应是膀胱糜烂治疗的首选。仔细和全面的尿道镜检查是强制性的在中尿道吊带手术。需要对中尿道吊带患者进行长期随访。我们报告2例晚期膀胱糜烂及膀胱结石形成的病例,原因是尿道中部聚丙烯吊带造成的网状物糜烂及处理。患者术后18至22个月出现血尿、复发性尿路感染和下尿路症状。采用气压碎石法粉碎结石,并采用26 Fr切除镜经尿道切除网状物。术后对照膀胱镜检查显示3个月后膀胱黏膜完全愈合。患者对这个结果感到满意,并且患者报告症状明显改善。在随访期间,患者保持完全自主。内窥镜下处理糜烂的补片应是膀胱糜烂治疗的首选。仔细和全面的尿道镜检查是强制性的在中尿道吊带手术。需要对中尿道吊带患者进行长期随访。
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