Surgical management of bladder erosion and pelvic pain after laparoscopic lateral suspension for pelvic organ prolapse

• Published in: International Urogynecology Journal 2020-04, Vol.31 (4), p.843-845
• Main Authors: Milani, Rodolfo, Manodoro, Stefano, Passoni, Paolo, Locatelli, Luca, Barba, Marta, Frigerio, Matteo
• Format: Article
• Language: English
• Subjects: Bladder; Gynecology; Hysterectomy; IUJ Video; Laparoscopy; Medicine; Medicine & Public Health; Pain; Urinary tract infections; Urology
• ISSN: 0937-3462; 1433-3023
• DOI: 10.1007/s00192-020-04261-0

Introduction and hypothesis Mesh-augmented lateral suspension for prolapse repair seems to be associated with few complications. However, mesh-related complications can negatively affect the quality of life and may be challenging to manage. This video is aimed at presenting the surgical management of a case of severe pelvic pain and dyspareunia after lateral laparoscopic suspension associated with mesh erosion in the bladder. Methods A 46-year-old woman was referred to our Unit for severe pelvic pain and inability to have sexual intercourses since undergoing a uterus-sparing laparoscopic lateral suspension procedure for genital prolapse 2 years before in another hospital. Moreover, she reported bladder pain and recurrent urinary tract infections. Cystoscopy showed mesh erosion in the bladder. She was admitted to laparoscopic hysterectomy plus subtotal mesh excision and bladder reconstruction (video). Results No surgical complications were observed. The postoperative course was uneventful. At the current follow-up, the patient reported complete resolution of her symptoms. Conclusion The featured video shows laparoscopic subtotal mesh excision, concomitant hysterectomy and bladder repair for pelvic pain, dyspareunia and bladder erosion after lateral suspension. This video may be useful in providing anatomical views and surgical steps necessary for achieving successful surgical management of this mesh-related complication.