The Management and Efficacy of Surgical Techniques Used for Erosive Mesh in the Urethra and Bladder: A Systematic Review

Urology. 2019 Dec:134:2-23. doi: 10.1016/j.urology.2019.08.001. Epub 2019 Aug 12.

Abstract

Background: This study reports the re-operation and symptom resolution rates of different techniques used in surgical excision of genitourinary mesh erosions.

Methods: A comprehensive systematic review was completed after searching electronic databases for studies involving outcomes of mesh erosion in humans that were managed surgically using a transvaginal, cystoscopic, or abdominal approach. Surgical outcomes were reported in percentages, ranges, and simple pooling to generate trends in management techniques.

Results: There were 177 cases that met our inclusion criteria. Forty-one patients underwent cystoscopic removal of eroded urethral mesh while 40 cases underwent transvaginal removal of urethral mesh.

Conclusions: For mesh eroded into the urethra, a transvaginal vs. cystoscopic approach showed a trend toward resolution of symptoms and fewer interventions. For mesh eroded into the bladder, abdominal and cystoscopic approaches had similar symptom resolution, but abdominal approach required fewer interventions.

Publication types

  • Systematic Review

MeSH terms

  • Comparative Effectiveness Research
  • Humans
  • Prosthesis Failure* / adverse effects
  • Prosthesis Failure* / etiology
  • Reoperation* / adverse effects
  • Reoperation* / methods
  • Surgical Mesh / adverse effects*
  • Urogenital Surgical Procedures* / adverse effects
  • Urogenital Surgical Procedures* / instrumentation
  • Urogenital Surgical Procedures* / methods