Conservative management of intravesical erosion of a synthetic mid-urethral sling for the treatment of stress urinary incontinence, based on patient preference: A case report.
Bladder
Erosion
Mesh
Stress urinary incontinence (SUI)
Tension-free vaginal tape (TVT)
Journal
Case reports in women's health
ISSN: 2214-9112
Titre abrégé: Case Rep Womens Health
Pays: Netherlands
ID NLM: 101682122
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
received:
17
12
2021
revised:
08
01
2022
accepted:
10
01
2022
entrez:
7
2
2022
pubmed:
8
2
2022
medline:
8
2
2022
Statut:
epublish
Résumé
Intravesical mesh erosion is an uncommon late complication of placement of a synthetic mid-urethral sling (MUS) for the treatment of stress urinary incontinence, and only a few cases have been reported. Optimal management remains controversial, though there is a tendency toward surgical removal through a variety of routes. However, surgical removal comes with its own risks and is not necessarily associated with an improvement in symptoms. We, herein present the first case of a conservatively managed intravesical mesh erosion following MUS placement. Nine years after insertion of a tension-free vaginal tape (TVT), a patient presented with persistent lower abdominal pain and dysuria. Flexible cystoscopy demonstrated an erosion of the tape through the bladder wall. The patient declined surgical intervention at the time. Therefore, she was commenced on regular methenamine hippurate and vaginal oestrogen, and kept under surveillance with regular cystoscopies. Her symptoms responded to this treatment and 6 years later remained well controlled on this regime. This case demonstrates that conservative management may be a safe and appropriate option for patients who decline surgical excision of mesh erosion.
Sections du résumé
BACKGROUND
BACKGROUND
Intravesical mesh erosion is an uncommon late complication of placement of a synthetic mid-urethral sling (MUS) for the treatment of stress urinary incontinence, and only a few cases have been reported. Optimal management remains controversial, though there is a tendency toward surgical removal through a variety of routes. However, surgical removal comes with its own risks and is not necessarily associated with an improvement in symptoms. We, herein present the first case of a conservatively managed intravesical mesh erosion following MUS placement.
CASE
METHODS
Nine years after insertion of a tension-free vaginal tape (TVT), a patient presented with persistent lower abdominal pain and dysuria. Flexible cystoscopy demonstrated an erosion of the tape through the bladder wall. The patient declined surgical intervention at the time. Therefore, she was commenced on regular methenamine hippurate and vaginal oestrogen, and kept under surveillance with regular cystoscopies. Her symptoms responded to this treatment and 6 years later remained well controlled on this regime.
CONCLUSION
CONCLUSIONS
This case demonstrates that conservative management may be a safe and appropriate option for patients who decline surgical excision of mesh erosion.
Identifiants
pubmed: 35127457
doi: 10.1016/j.crwh.2022.e00383
pii: S2214-9112(22)00003-0
pmc: PMC8810362
doi:
Types de publication
Case Reports
Langues
eng
Pagination
e00383Informations de copyright
© 2022 Published by Elsevier B.V.
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