A case of mesh plug migration into the bladder 5years after hernia repair.

Shinji Ishikawa,Ryuichi Karashima,Masahiko Hirota,Tetsumasa Arita,Takashi Kawano,Yasushi Yagi

doi:10.1186/s40792-014-0004-2

Shinji Ishikawa, Ryuichi Karashima + Show 4 more

Open Access

https://doi.org/10.1186/s40792-014-0004-2

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Abstract

The mesh plug technique is one of the most popular procedures for inguinal hernia repair in Japan. This procedure is quick, easy, and low cost with a low recurrence rate. However, some complications associated with the mesh plug have been reported recently. We hereby present a case of an 80-year-old female admitted to our hospital with swelling and pain in the right lower abdomen 5 years after hernia repair with the PerFix plug. Discharge of urine through the route of exploratory needle puncture demonstrated the fistula of skin and the bladder. Computed tomography (CT), magnetic resonance imaging (MRI), abdominal US, and cystoscope examination revealed that the mesh plug had penetrated into the bladder. As far as we know, this is the first report that a mesh plug has migrated into the bladder.

Highlights

Endoscopic repair or Lichtenstein method is recommended for inguinal hernia repair by the European Hernia Society Guidelines [1]
Hernia repair using a mesh plug is more common in Japan, and more than 80% of adult inguinal hernia cases have been treated by using this technique in our hospital
As the inguinal hernia was a direct hernia, the mesh plug was inserted into the transversal fascia, and this position is in the vicinity of the bladder

Summary

Background

Endoscopic repair or Lichtenstein method is recommended for inguinal hernia repair by the European Hernia Society Guidelines [1]. There were five reported cases that indicated the complication being caused by mesh plug migration. We report a complicated case of mesh plug migration into the bladder 5 years after hernia repair with PerFix Plug (Bard Co., Murray Hill, NJ, USA). Case presentation An 80-year-old female was admitted to our hospital with right inguinal pain and fever. She underwent a direct inguinal hernia repair with PerFix Mesh 5 years before. Though the onlay mesh was removed from the inguinal incision (Figure 3a), Ishikawa et al Surgical Case Reports (2015) 1:4. We performed an additional laparotomy in the mid lower abdomen and removed the mesh plug from the bladder (Figure 3b) and repaired the bladder. Any recurrence of hernia has not been observed

Discussion

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Conclusions