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Vol. 39. Issue 3.
Pages 183-187 (April 2015)
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Vol. 39. Issue 3.
Pages 183-187 (April 2015)
Skill and talent
DOI: 10.1016/j.acuroe.2015.02.009
Outcomes of transurethral resection (TUR) of intravesical mesh after suburethral slings in the treatment of urinary stress incontinence
Resultados de la resección transuretral (RTU) de malla intravesical tras tratamiento con cintillas suburetrales para la incontinencia urinaria de esfuerzo
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F. Castroviejo-Royo
Corresponding author
fatimacasroyo@hotmail.com

Corresponding author.
, L.A. Rodríguez-Toves, J.M. Martínez-Sagarra-Oceja, C. Conde-Redondo, J.A. Mainez-Rodríguez
Servicio de Urología, Hospital Universitario Río Hortega, Valladolid, Spain
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Tables (2)
Table 1. Description of the type of previous surgery, location, presence of lithiasis, and the time to start with the symptoms and the time when intravesical mesh has been diagnosed and treated.
Table 2. Description of the type of previous surgery, date of treatment of the resection of the intravesical mesh, surgical time (minutes), hospital stay (days), follow-up (months), if it has been demonstrated during the follow-up, residual mesh, and complications.
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Abstract
Objective

The objective of this study was to determine the efficacy as well as the complications associated with transurethral removal (TUR) of intravesical mesh, after suburethral sling, transobturator tape-TOT (Monarc™) or “minisling” (MiniArc®), in the treatment of female urinary stress incontinence (USI).

Materials and methods

A retrospective and consecutive study on 9 women with bladder perforation after midurethral slings (3 Monarc™ and 6 MiniArc®) placement for urinary stress incontinence. To remove the mesh, transurethral resection with an electrode loop (TUR-E) was used. The technique included location and total removal of mesh up to healthy tissue with bipolar resectoscope.

Results

The median age was 61 years (49–70 years). The median time between midurethral sling placement and onset of the symptoms was 13 months (1–79 months) and between sling placement and mesh removal it was 16 months (1–91 months). Five women (55.5%) developed bladder stones. Mean operating time was 29.4±10.4min and mean length of hospital stay was 2.6±0.5 days. The median follow-up after mesh removal was 38 months (range, 14–109 months). No complications were found.

Conclusions

The use of transurethral resection of intravesical mesh after suburethral slings is easy and the results obtained by our surgical team are excellent.

Keywords:
Mesh complications
Suburethral slings
Transurethral resection
Resumen
Objetivo

El objetivo de este estudio fue determinar la eficacia y las complicaciones asociadas con la resección transuretral (RTU) de malla intravesical después de la cirugía con TOT (Monarc™) o «minisling» (MiniArc®) para tratar la incontinencia urinaria de esfuerzo femenina (IUE).

Material y métodos

Estudio retrospectivo de 9 mujeres consecutivas, todas ellas con perforación intravesical de cintilla suburetral: 3 en pacientes tratadas con cabestrillo transobturador, Monarc™ y 6 en pacientes con «minisling», MiniArc®. Todas las pacientes fueron tratadas con RTU con asa con energía bipolar. La técnica incluye la identificación de la malla intravesical, la eliminación completa con el resector de energía bipolar hasta que no era visible más malla y se alcanzó el tejido sano perivesical.

Resultados

La edad media de nuestras pacientes fue de 61 años. El tiempo medio de aparición de síntomas tras la cirugía por IUE fue 13 meses (1-79) y el tiempo medio hasta la RTU de 16 meses (1-91). Cinco mujeres (55,5%), desarrollaron litiasis vesicales.

El tiempo de operación promedio fue de 29,4±10,4min y la estancia media hospitalaria fue de 2,6±0,5días. La mediana de seguimiento fue de 38 meses (rango: 14-109 meses) después de la eliminación de malla. No se encontraron complicaciones.

Conclusión

El uso de la resección transuretral para tratar las perforaciones vesicales tras cirugía vaginal con malla es fácil de realizar y en nuestro grupo tiene excelentes resultados.

Palabras clave:
Complicaciones
Sling suburetral
Resección transuretral

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