Holmium:YAG Laser Ablation for the Management of Lower Urinary Tract Foreign Bodies Following Incontinence Surgery: A Case Series and Systematic Review

Chan, Garson; Mamut, Adiel; Martin, Paul J.; Welk, Blayne

doi:10.1089/end.2016.0557

Cited by 12 publications

(5 citation statements)

References 32 publications

(17 reference statements)

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“…Our search produced 931 articles of which 155 abstracts were reviewed and 20 articles (198 patients) met our inclusion criteria and were included in our final review ( Fig. 1) [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][25][26][27]. The removal of eroded sling/mesh was done by laser incision in nine studies, endoscopic approach using transurethral resection (TUR) or cutting it with scissors in seven studies and a mixture of the above two techniques in the remaining four studies (Table 1).…”

Section: Resultsmentioning

confidence: 99%

Role of endoscopic management in synthetic sling/mesh erosion following previous incontinence surgery: a systematic review from European Association of Urologists Young Academic Urologists (YAU) and Uro-technology (ESUT) groups

et al. 2019

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Introduction and hypothesis Foreign body (FB) erosion is now recognized as a major long-term complication following previous incontinence surgery. The aim of our systematic review was to ascertain the outcomes of endoscopic management in synthetic sling/mesh erosion following previous gynaecological surgery. Methods A systematic review in line with PRISMA and Cochrane guidelines was conducted for all English language articles between 1996 and December 2018 for all articles reporting on endoscopic surgical management for eroded FB following previous sling/mesh procedure for incontinence. Results Our search produced 931 articles of which 20 articles (198 patients) were included in our review; 149 (75%) had tensionfree vaginal tapes (TVT) or tension-free obturator tapes (TOT) as their initial procedure. The site of mesh erosion was the bladder in 134 patients (68%) of which 12 (6%) were in the bladder neck. Urethral mesh erosion was seen in 63 patients (32%) across all studies.The treatment of eroded mesh was by laser and endoscopic excision using an electrode loop or laparoscopic scissors in 108 (55%) and 90 (45%) patients respectively. The initial/final success rate with laser and endoscopic excision was 67%/92% and 80%/98% respectively. The overall complication rates were 24% and 28% in laser and endoscopic groups respectively of which 21% in each group were stress urinary incontinence. Conclusions Endoscopic management of FB erosion is an effective minimally invasive technique with good outcomes and minimal morbidity. Management with the use of holmium laser is gaining momentum and could be attempted before open surgical removal. There is a need for comparative data between open surgical excision and endoscopic excision to help better describe the patient's most likely to benefit from the endoscopic technique.

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Section: Resultsmentioning

confidence: 99%

Role of endoscopic management in synthetic sling/mesh erosion following previous incontinence surgery: a systematic review from European Association of Urologists Young Academic Urologists (YAU) and Uro-technology (ESUT) groups

et al. 2019

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“…More recently, the holmium laser has been studied as a less invasive tool to remove perforated mesh exposed in the lower genitourinary tract endoscopically . A recent literature review identified 16 case series of lower urinary tract foreign bodies after female SUI surgery treated with endoscopic procedures, including 9 series in which holmium or thulium laser treatment was used to treat a total of 43 bladder perforations and 12 UP . There were only 2 endoscopic series limited in scope to UP, describing a total of 7 patients who underwent transurethral excision with satisfactory results at 2–24 months .…”

Section: Discussionmentioning

confidence: 99%

Long‐term results of transurethral endoscopic excision using the holmium laser for urethral perforation of synthetic slings

Wang

Lemack

2018

LUTS

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“…Although most authors agree that removal of eroded materials is necessary, there is no consensus as to which method is preferable [9, 18, 19]. Authors presented isolated cases of bladder erosion in small numbers of patients [4–8, 20], Erosions are usually removed using the open technique.…”

Section: Discussionmentioning

confidence: 99%

Transvesical laparoendosopic single-site surgery as a valuable option to remove eroded materials from the bladder: single-center experience and a review of the literature

et al. 2018

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Introduction Currently, polypropylene materials are used widely for the treatment of various urogynecologic disorders. This type of treatment can be complicated, although rarely, with erosions of the polypropylene implants into the bladder or the urethra. There is no established treatment for such complications. We present our experience in transvesical laparoendoscopic single-site surgery (T-LESS) removal of eroded materials, and a review of the literature in this field. Materials and methods From June 2015 to May 2017 eight females, with an average age of 66.5 years (range 55–80 years), were referred to our Center because of the erosion of polypropylene material in the bladder, after anti-incontinence or pelvic organ prolapse treatment. Patients were diagnosed with ultrasound and cystoscopy. Seven bladder erosions and one bladder and urethral penetration were found. Patients were qualified for removal with the T-LESS approach. The Tri-Port + disposable set and standard laparoscopic instruments were used. The eroded materials were dissected and cut away, and the defects of the bladder wall were closed with barbed sutures. The peri-operative efficacy and safety of the method were assessed, and the patients were scheduled for follow-up visits at 6 weeks and every 3 months thereafter. The patients were offered a cystoscopic exam during the 7–10 month period after the operation. Results The procedures were completed successfully in all patients. No blood loss or complications were observed. The mean operative time was 54.5 min, and the average hospital stay was 30 h. During a follow-up at 11 months, all patients were cured, except for one who presented urethral erosion. Conclusions The T-LESS technique for removal of eroded meshes is a safe and effective method. The precise access to the bladder minimizes morbidity, and suturing the bladder wall defects may reduce the risk of recurrence.

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Holmium:YAG Laser Ablation for the Management of Lower Urinary Tract Foreign Bodies Following Incontinence Surgery: A Case Series and Systematic Review

Abstract: Both our case series and the systematic review of the literature demonstrated that endoscopic treatment of lower urinary tract foreign bodies after stress incontinence surgery has good success rates and minimal morbidity.

Cited by 12 publications

References 32 publications

Role of endoscopic management in synthetic sling/mesh erosion following previous incontinence surgery: a systematic review from European Association of Urologists Young Academic Urologists (YAU) and Uro-technology (ESUT) groups

Role of endoscopic management in synthetic sling/mesh erosion following previous incontinence surgery: a systematic review from European Association of Urologists Young Academic Urologists (YAU) and Uro-technology (ESUT) groups

Long‐term results of transurethral endoscopic excision using the holmium laser for urethral perforation of synthetic slings

Transvesical laparoendosopic single-site surgery as a valuable option to remove eroded materials from the bladder: single-center experience and a review of the literature

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