Complications of synthetic graft materials used in suburethral sling procedures

Abstract

Problems relating to the erosion of sling material, through either the vagina or the urethra, have been encountered with almost all kinds of synthetic sling materials. We present four unusual cases of women using different synthetic materials and the complications that occurred. The biopsies were examined histologically and analyzed for collagen and inflammatory reactions. Four patients who underwent suburethral slingplasty previously with different sling materials required surgical management for complications, including one intravesical Ethibond migration, vaginal mucosal mesh erosion in two patients, and one proximal urethral overcorrection with intravesical erosion. We reviewed the literature regarding the amount of mesh erosion and connective tissue reaction with synthetic materials. The efficiency of mesh removal was assessed. The four patients maintained urinary continence after urethrolysis and removal of the mesh. Fibrosis and severe inflammatory reactions were found in the connective tissue adjacent to the mesh as well as the Prolene mesh. Technically, it would be easier to remove the graft of patch sling if rejection or erosion occurs.

Experimental Animal Model for Training Transobturator and Retropubic Sling Techniques

“…Despite being simple and attractive, these procedures are not complication-free and there is a learning curve as well [6][7][8] .…”

Mesh infection without erosion after ObTape sling insertion: a diagnostic challenge

“…At some point, she complained of bloodstained vaginal discharge, which is one of the presentations of mesh erosion [22]; however no erosion was detected despite repeat cystoscopy. The infection was only diagnosed when she developed a discharging abscess.…”

Suburethral Slingplasty Using a Self-Fashioned Mesh for Treating Urinary Incontinence and Anterior Vaginal Wall Prolapse

“…A mesh patch lessens the amount of synthetic materials present in the wound bed which might diminish potential complications. Technically, it would be easier to remove the mesh patch than the full-length mesh if late complications occur (Tsui et al 2005 …”