Delayed mesh erosion after rectopexy: A rare surprise diagnosis

Abstract

Mesh rectopexy is a frequently performed surgery for the treatment of rectal prolapse. Mesh rectopexy may be complicated by mesh infection, mesh erosion/migration into bowel wall, and extrusion of mesh. Erosion of the mesh into the rectum is very rare. Delayed erosion of mesh into rectosigmoid can present after many years of mesh rectopexy and poses diagnostic dilemma. We report a case of delayed mesh erosion into the rectum diagnosed during sigmoidoscopy.

The Development of Equipment to Measure Mesh Erosion of Soft Tissue

“…The result is that the mesh tape can damage the tissue, causing pain and discomfort. Sometimes the mesh cuts completely through the organ wall, emerging inside the vagina, rectum or bladder, for instance [2,11]. Figure 1 shows an example of a piece of [1] and (b) a photograph of a piece of mesh, which was surgically removed after eroding through the wall of the patient's bladder [2].…”

“…In the case of mesh products used for SUI and POP, we found publications reporting mechanical property data [ 13 , 14 ] and a few animal studies (e.g., [ 15 ]). We also found a large number of clinical case reports describing mesh erosion and other complications (e.g., [ 2 , 11 ]) and summaries of complications from large-cohort follow-up studies and meta-analyses [ 7 , 8 , 9 ]. However, as far as the open published literature is concerned, there appeared to be no in vitro studies of mesh erosion, so in 2019 we embarked on a program of work to develop equipment for this purpose.…”