Mesh erosion into the urinary bladder following laparoscopic inguinal hernia repair; is this the tip of the iceberg?

Abstract

A 67-year-old man presented with recurrent sepsis, groin swelling, and lower urinary tract symptoms 12 years after bilateral TEP inguinal hernia repair. Diagnosis of mesh migration and erosion into the urinary bladder was made by cystoscopy. Exploration of the groin confirmed Prolene mesh erosion into the lateral wall of the urinary bladder. This is the second reported case following TEP repair. A review of the literature reveals eight reported cases following laparoscopic repair since 1994. The factors contributing to mesh migration and erosion are discussed. With large case series of mesh non-fixation being reported in world literature, it may be that the incidence of this complication will increase in the future. A lower diagnostic threshold and reporting of this complication should be encouraged.

Mesh Migration Into Urinary Bladder After Open Ventral Herniorrhaphy With Mesh: A Case Report

“…The most frequent presentations of mesh migration into the urinary bladder reported in previous literatures [3][4][5][6] were irritating lower urinary tracts symptoms as in foreign body in the urinary bladder.…”

“…It has been reported in some patients with a surgical history of either open or laparoscopic herniorrhaphy with mesh. [3][4][5][6][7][8] In this case report, a 77-year-old man, who underwent ventral hernia repair with mesh before, had the complication of mesh migration into the urinary bladder and enterovesical fistula with the initial presentation of lower urinary tract symptoms.…”

Bladder Erosion and Stone as Rare Late Complication of Laparoscopic Hernia Meshplasty: Is Endoscopic Management an Option?

“…Such migrations have been more common after transabdominal pre-peritoneal (TAPP) repair than after total extraperitoneal repairs. It occurs more frequently after non-fixation of the mesh [1]. Our case was a follow-up of TAPP, but details regarding mesh fixation were not available.…”

“…Very few such cases of bladder complications due to mesh migration after laparoscopic repair have been reported with various presentations [1][2][3][4]. Three patients have presented with hematuria; two, with colovesical fistula; two, with recurrent urinary tract infection; and one patient each, with dysuria, a sinus, and a bladder stone.…”

Irritable Bowel Syndrome: A "Mesh" of a Situation

“…Mesh migration often can mimic ovarian and colonic malignancy 16,17 by creating a tissue "masses" noted on CT scan. The numerous accounts of mesh migration led Hamouda et al 12 to conclude that this was a time-dependent and insidious effect, and that we were seeing "the tip of the iceberg" because complications from mesh migration may increase in prevalence over time.…”