Midurethral slings are the most widely used surgical treatment for stress urinary incontinence. Complications include bladder injury, voiding dysfunction, mesh exposure/erosion, dyspareunia, and failure to correct the incontinence. Complete mesh infection is rare.
A 48-year-old woman underwent a repeat retropubic tension-free vaginal tape (TVT) procedure for stress urinary incontinence. She presented eight weeks postoperatively with a tender suprapubic mass and urinary retention. A CT scan demonstrated thickening of the bladder wall and cystoscopy revealed severe inflammation with no intramural injury. The sling appeared to be infected and was removed vaginally. The patient's symptoms resolved following removal of the sling.
Mesh infection following a midurethral sling procedure is rare. In suspected cases, cystoscopy should be performed to rule out bladder injury. Antibiotic therapy may be successful, but removal of the sling may be required for resolution of symptoms.
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC. 2016 Jul 07 [Epub]
Laura Didomizio, Hisham Khalil, Dante Pascali
Division of Urogynecology, Department of Obstetrics and Gynecology, The Ottawa Hospital, Ottawa ON.