Mesh erosion into the bladder: A late complication of incisional hernia repair. A case report and review of the literature

Abstract

Late complications of mesh repair are commonly due to mesh migration and erosion into neighbouring visceri. We report the first case of a mesh repair of a lower midline laprotomy incisional hernia complicated by erosion of the mesh into the bladder which presented as haematuria.

Laparoscopic repair of incisional hernia: Outcomes of 100 consecutive cases comprising 25 wall defects larger than 15 cm

“…The surgical management of incisional hernias before the use of prosthetic meshes had a 12-54% rate of recurrence, but in the last two decades the use of meshes has dramatically reduced the recurrence rate [2,6,14]. Adversely, serious complications, before unknown, have been noted with the new techniques, such as migration of meshes into the urinary bladder or other hollow viscus, peritoneal adhesions, intestinal obstruction, and persistent pain for 6-8 weeks [3,4,7,[15][16][17][18]. The introduction of minimally invasive techniques has changed the approach to surgical management of incisional hernia.…”

Unusual Timing of Mesh Migration Following Inguinal Hernioplasty: A Case Report and Literature Review

“…The secondary type has been identified as tissue inflammation due to a foreign body reaction that could lead to the erosion of the surrounding tissues. Some authors mentioned that predisposing factors could include sharp edges of the mesh (11,24); no fixation with sutures or staples (14) or improper fixation (7,24) of the mesh; a history of urological surgery; and an intraoperative non-drained or overfilled bladder and the use of a laparoscopic transabdominal preperitoneal approach (TAPP) (18).…”

“…The conditions most frequently experienced by patients presenting with this type of mesh migration include hematuria (10,13,14,16,17,19,21,24) and recurrent/persistent urinary tract infection (6-8, 12, 15, 21, 23). Hematuria may be painless, or it may also be present with irritative symptoms.…”

Mesh erosion following laparoscopic incisional hernia repair

“…The bio-absorbable layer is rolled inwards to avoid damage when passing it through the port. Mesh migration can lead to erosion into adjacent structures [5][6][7]. One hypothesis is that the sharp or angulated edges of the mesh may cause a traumatic reaction to the tissue to which it becomes adherent.…”