Outcomes of transurethral resection (TUR) of intravesical mesh after suburethral slings in the treatment of urinary stress incontinence

Castroviejo-Royo, F.; Rodríguez-Toves, L.A.; Martinez-Sagarra-Oceja, J.M.; Conde-Redondo, C.; Mainez-Rodríguez, J.A.

doi:10.1016/j.acuroe.2015.02.009

Cited by 1 publication

(2 citation 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%

“…Endoscopic management of eroded foreign body (FB) can be performed by intravesical resection of the mesh with electrode loop via a resectoscope or laparoscopic scissors [17][18][19][20], although it has been increasingly popular to use transurethral endoscopic resection using holmium laser [21]. These are minimally invasive approaches to a complex clinical problem.…”

Section: Introductionmentioning

confidence: 99%

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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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