V01-04 ADJUSTABLE AUTOLOGOUS SLING: A FEASIBLE SOLUTION FOR A COMPLEX MESH COMPLICATION

Abstract

You have accessJournal of UrologyIncontinence & Female Pelvic Medicine/Reconstructive Surgery (V01)1 Sep 2021V01-04 ADJUSTABLE AUTOLOGOUS SLING: A FEASIBLE SOLUTION FOR A COMPLEX MESH COMPLICATION Oriol Colet, Iván Sáez Moreno, Jaime Bolón Marset, Oriol Dagà Martínez, Francisco Gómez Palomo, Adrián Bernal Gómez, Juan Ortiz Salvador, Álvaro Beviá Romero, Salvador Arlandis, Eduardo Morán, Esther Martínez Cuenca, Miguel Ángel Bonillo, Enrique Broseta, and Francisco Boronat Oriol ColetOriol Colet More articles by this author , Iván Sáez MorenoIván Sáez Moreno More articles by this author , Jaime Bolón MarsetJaime Bolón Marset More articles by this author , Oriol Dagà MartínezOriol Dagà Martínez More articles by this author , Francisco Gómez PalomoFrancisco Gómez Palomo More articles by this author , Adrián Bernal GómezAdrián Bernal Gómez More articles by this author , Juan Ortiz SalvadorJuan Ortiz Salvador More articles by this author , Álvaro Beviá RomeroÁlvaro Beviá Romero More articles by this author , Salvador ArlandisSalvador Arlandis More articles by this author , Eduardo MoránEduardo Morán More articles by this author , Esther Martínez CuencaEsther Martínez Cuenca More articles by this author , Miguel Ángel BonilloMiguel Ángel Bonillo More articles by this author , Enrique BrosetaEnrique Broseta More articles by this author , and Francisco BoronatFrancisco Boronat More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001970.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: One of the main complications caused by the use of surgical techniques for transvaginal correction of pelvic organ prolapse is extrusion of the mesh. This aim of this video is to describe the excision of the mesh and the following treatment of the stress urinary incontinence with an adjustable autologous sling. METHODS: 73-year-old woman with a story of abdominal hysterectomy and cystocele corrected by Prolift mesh, with a recurrence treated by partial colpocleisis with intravesical and vagina extrusion of the mesh, which caused vesicovaginal fistula and stress urinary incontinence diagnosed by cystoscope and pelvic MRI. She suffered an intense pain in the hypogastrium (9/10 points in the Visual Analogue Scale Pain, VASP). The recording was approved by the Institution Ethics Committee. RESULTS: We catheterized both ureters. We removed the calcifications as well as the extruded mesh by an incision in the previous partial colpocleisis. We located and closed the fistula in 3 layers, creating a Martius flap transposed to the vagina. Finally, the stress urinary incontinence was corrected by means of an adjustable autologous sling with the abdominal rectus fascia. The patient presented a favorable postoperative period. Currently, the patient has not pain and has not stress urinary incontinence or voiding and storage symptoms. CONCLUSIONS: The extrusion and calcification of the mesh to correct the prolapse of the pelvic organs is a complication that causes a great impact on the quality life of patients. The treatment of this complication involves the removal of the mesh and the treatment of the associated complications, which can be solved in the same surgical act. The use of an adjustable system with replacement of the synthetic mesh by autologous tissue can be a feasible solution for a complex mesh complication. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e63-e63 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Oriol Colet More articles by this author Iván Sáez Moreno More articles by this author Jaime Bolón Marset More articles by this author Oriol Dagà Martínez More articles by this author Francisco Gómez Palomo More articles by this author Adrián Bernal Gómez More articles by this author Juan Ortiz Salvador More articles by this author Álvaro Beviá Romero More articles by this author Salvador Arlandis More articles by this author Eduardo Morán More articles by this author Esther Martínez Cuenca More articles by this author Miguel Ángel Bonillo More articles by this author Enrique Broseta More articles by this author Francisco Boronat More articles by this author Expand All Advertisement Loading ...