Bladder Calculi in Women After Urethrovesical Suspension

Abstract

There have been a number of reports recently on vesical calculi in women with a history of gynecological procedures. Within 1 year we encountered 2 patients with vesical calculi after vesicourethral suspension performed with concomitant hysterectomy. These calculi formed on a retained intravesical suture and a monofilament knitted polypropylene pledget, and they produced interesting pathological and radiographic findings.

Suture Related Iatrogenic Bladder Stone

“…Some urological and non-urological surgeries with proximity to bladder have been reported to have such a complication (4,5,6,7,8,9,10,11). Nonurological surgeries are mostly incontinence surgeries including Marshall-Marchetti-Krantz operation, Burch colposuspension, laparoscopic colposuspension and even tension free vaginal tape procedure (6,7,8,9,10). In most of the procedures, as in our case, the suture materials were non-absorbable (4,6,7,8,9,10,11).…”

“…Nonurological surgeries are mostly incontinence surgeries including Marshall-Marchetti-Krantz operation, Burch colposuspension, laparoscopic colposuspension and even tension free vaginal tape procedure (6,7,8,9,10). In most of the procedures, as in our case, the suture materials were non-absorbable (4,6,7,8,9,10,11). However, iatrogenic bladder stone formation due to absorbable suture has also been reported after a urological surgery (5).…”

“…The suture material acts as a nidus for aggregation of crystals and eventually stone forms around it. Some urological and non-urological surgeries with proximity to bladder have been reported to have such a complication (4,5,6,7,8,9,10,11). Nonurological surgeries are mostly incontinence surgeries including Marshall-Marchetti-Krantz operation, Burch colposuspension, laparoscopic colposuspension and even tension free vaginal tape procedure (6,7,8,9,10).…”

“…The cases mostly had lower urinary tract symptoms and/or hematuria after one to fourteen years of their related surgeries (5,6,7,8,9,10,11). However, it might be asymptomatic and diagnosed in postmortem study though huge bladder stone with size of 9x1 cm (4).…”

“…Though care related to choice of suture and technique of suturing is taken for bladder related surgeries and others with proximity to bladder, still such cases are reported after both urological (4,5) and non-urological surgeries, mostly incontinence surgeries (6,7,8,9,10,11). In this report, such a case is presented together with radiological examinations and endoscopical visualizations.…”