1346 OUTCOMES OF TRANSURETHRAL REMOVAL OF INTRAVESICAL OR INTRAURETHRAL MESH FOLLOWING MIDURETHRAL SLING SURGERY

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Incontinence - Evaluation & Therapy III1 Apr 20121346 OUTCOMES OF TRANSURETHRAL REMOVAL OF INTRAVESICAL OR INTRAURETHRAL MESH FOLLOWING MIDURETHRAL SLING SURGERY Dong-Soo Ryu, Young-Suk Lee, Tae-Hee Oh, and Kyung-Won Kwak Dong-Soo RyuDong-Soo Ryu Changwon, Korea, Republic of More articles by this author , Young-Suk LeeYoung-Suk Lee Changwon, Korea, Republic of More articles by this author , Tae-Hee OhTae-Hee Oh Changwon, Korea, Republic of More articles by this author , and Kyung-Won KwakKyung-Won Kwak Changwon, Korea, Republic of More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1729AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Intravesical and intraurethral mesh following midurethral sling procedure to treat female stress urinary incontinence are not common, but troublesome complications. We assessed our experience with transurethral removal of intravesical or intraurethral mesh with an electrode loop or a Holmium laser. METHODS The 23 consecutive women who underwent transurethral removal of mesh with an electrode loop (TUR-E) in 16 and a Holmium laser (TUR-H) in 7 at our institution between January 2002 and December 2010 were included. Of the 23 patients, 20 (87%) were intravesical mesh and remaining 3 (13%) were intraurethral mesh. When the stone fomation from the mesh was found, lithotrisy was performed with a lithoclast or Holmium laser. RESULTS At the time of surgery, the median age of patient was 51 (range, 40-67) years, and 17 women (74%) had calculi. The median period between the midurethral sling and mesh removal was 31.3 (2.2-247.6) months, and the median follow-up period after mesh removal was 2.1 (0.3-35.9) months. Twenty-six percent of women (6/23) had a mesh remnant; 6.2% (1/16) of women treated with TUR-E and 71.4% (5/7) of women treated with TUR-H. Of the five women treated with TUR-H, 3 underwent concomitant transvaginal removal. On the follow-up cystoscopic exam, a mesh remnant was observed in three women (one treated with TUR-E and two treated with TUR-H). Vesico-vaginal fistula were found in two women during and after TUR-E. Stress urinary incontinence recurred in one woman. CONCLUSIONS Transurethral resection of mesh after the midurethral sling procedure has good functional outcomes, low surgical mobidity, and low risk of recurrence of stress incontinence. Transurethral resection with a electode loop has better success rate than Holmium laser because this had narrow range of motion of the instrument. However, TUR-E might has a risk of bladder perforation while TUR-H has minimal risk of tissue damage. Therefore, the choice of the best treatment modality should be selected according to the location of mesh and the availability of instruments. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e546 Peer Review Report Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Dong-Soo Ryu Changwon, Korea, Republic of More articles by this author Young-Suk Lee Changwon, Korea, Republic of More articles by this author Tae-Hee Oh Changwon, Korea, Republic of More articles by this author Kyung-Won Kwak Changwon, Korea, Republic of More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...