Urethral synthetic mesh erosion with formation of a large bladder and urethral stone: A case report

Abstract

Synthetic urethral support mesh has been used for many years for the treatment of urinary stress incontinence. Late complications such as pain, mesh erosion, and recurrent urinary tract infection have been well described. A 57-year-old patient presented with a primary complaint of worsening lower urinary tract obstruction. She had undergone placement of a pubovaginal tension-free vaginal tape for the treatment of urinary stress incontinence 13years earlier. A workup revealed a large stone arising from a section of mesh that had eroded into the proximal urethra. The stone extended from the erosion site into the bladder, creating a high-grade obstruction at the bladder neck. It is quite uncommon to see such a large stone in this setting. The long interval between the original surgery and the subsequent presentation of this complication is also unusual. A high index of suspicion is needed to evaluate late urologic complications related to implanted synthetic mesh.