Endoscopic Removal of an Intravesical Calcified Sling Using Pneumatic Lithotripsy and Cystoscopic Resection

Abstract

The transobturator tape procedure is a minimally invasive treatment for stress urinary incontinence. The widespread use of these slings has led to an increase in the number of rare complications, such as bladder erosion. Although in the last few years several minimally invasive techniques have been described, surgical management of such complications remains an open issue. We report a case of a bladder stone formed on a transobturator sling after unrecognized bladder perforation. Using pneumatic lithotripsy, the calculus was fragmented and the intravesical portion of the tape was successfully excised and removed by transurethral resection and endoscopic scissors. This minimally invasive transurethral technique is challenging but can be a safe and successful way to deal with such rare complications.

Mesanede taşlaşmış transobturator bant meşi: Olgu sunumu

“…An endoscopic method may also be preferred for excision of the calcified sling, instead of open surgery. Osorio et al successfully performed pneumatic lithotripsy and cystoscopic resection for the treatment of a calcified sling (8). European Association of Urology (EAU) panel meta-analysis compared retropubic and transobturator mid-urethral slings in 34 randomized controlled trials (5786 women).…”

Do we have adequate data to construct a valid algorithm for management of synthetic midurethral sling complications? ICI‐RS 2019

“…[35][36][37][38][39][40][41] Transurethral resection has been reported in 49 cases with a 6% recurrent erosion rate, a 22% recurrent SUI rate, and a 2% vesicovaginal fistula rate at between 2 and 18 months of follow up. [42][43][44][45][46][47][48][49][50][51][52] Excision using holmium laser was performed in 90 cases, and after a follow up of 7 to 27 months, recurrent erosion was seen in 33%, recurrent SUI in 13%, and vesicovaginal fistula in 4%. [53][54][55][56][57][58][59][60][61][62] Combination endoscopic treatment was reported in 49 cases with a follow up of 12 months, and 20% developed recurrent erosion and 14% developed recurrent SUI.…”

“…Transurethral incision has been reported in fewer than 15 cases to date with 7% of patients having recurrent mesh erosion at a very short follow up ranging from 1 to 3 months 35–41 . Transurethral resection has been reported in 49 cases with a 6% recurrent erosion rate, a 22% recurrent SUI rate, and a 2% vesicovaginal fistula rate at between 2 and 18 months of follow up 42–52 . Excision using holmium laser was performed in 90 cases, and after a follow up of 7 to 27 months, recurrent erosion was seen in 33%, recurrent SUI in 13%, and vesicovaginal fistula in 4% 53–62 .…”