Akademik Veri Yönetim Sistemi
ESGE 34 th Annual Congress, İstanbul, Türkiye, 19 - 22 Ekim 2025, ss.366, (Özet Bildiri)
Background
A 60-year-old patient presented to our clinic in October 2024 with complaints of urinary
incontinence, recurrent urinary tract infection, and pelvic pain. The patient's medical history revealed
previous surgeries, including two midurethral sling procedures performed approximately ten years
ago, six months apart. The procedures were performed via transobturator and retropubic
approaches, respectively. Pelvic ultrasonography revealed that the mesh had eroded into the bladder
and extended into the bladder lumen. Considering the severity of the patient's current symptoms
and the localization of the mesh, removal of the eroded mesh was planned via a transvesical
approach through two trocars inserted from the suprapubic area under cystoscopic guidance.
Following surgical removal of the mesh, the patient's pain resolved; however, urinary incontinence
persisted. Considering the history of multiple prior surgeries for urinary incontinence, a periurethral
bulking agent injection was attempted as a treatment. After the injection, the patient reported a
noticeable improvement in urinary leakage.
Methods
While the bladder and the intravesical mesh were being visualized under cystoscopic guidance, the
procedure was initiated by transvesically inserting two 3 mm trocars into the bladder, which had
been distended with saline and elevated toward the suprapubic area. Following this, the mesh ends
protruding into the bladder were identified, grasped, and freed using a grasper and scissors inserted
through the trocars, and subsequently extracted transurethrally.
Results
The procedure was completed without complications. No recurrent erosion of the bladder mucosa by
the mesh was observed within the 3-month follow-up period.
Conclusions
Using either the abdominal or transvaginal approach to excise eroded mesh requires subsequent
closure of the bladder defect, causing more trauma to the patient. Consequently, we preferred a
new, minimally invasive treatment for mesh erosion into the bladder.