Transurethral Resection of Intravesical Mesh After Midurethral Sling Procedures

We evaluated the efficacy of the transurethral resection (TUR) for the management of intravesically exposed polypropylene mesh after midurethral sling (MUS) procedures. Fourteen patients had a TUR for intravesical mesh after MUS procedures (tension-free vaginal tape, 11; transobturator tape, 3). In six patients with large stones, cystoscopic division and cystolitholapaxy were needed before the TUR. Patients presented with dysuria (9), hematuria (7), urgency incontinence (5), urinary frequency (2), and pelvic pain (2). Thirteen of 14 (92.9%) patients had the mesh completely removed during a mean follow-up of 18 months; one patient had a recurrent bladder stone. Complications included de novo mixed incontinence, pelvic hematoma, and vesicovaginal fistula among three patients. Urologists should suspect intravesical mesh erosion or stone formation in patients with persistent pain, hematuria, or bladder irritation symptoms after MUS procedures. The TUR was a useful treatment modality for patients with intravesical complications after MUS procedures.