Mesh migration following repair of inguinal hernia: a case report and review of literature

Abstract

New surgical procedures in the aftermath of their benefits beget new complications as well. Laparoscopic repair of inguinal hernia is widely practised now. It involves reinforcement of hernial defect with a synthetic mesh. We report a rare case of migration of mesh into urinary bladder following this mode of hernial repair. We also present a review of literature involving migration of mesh following all inguinal hernial repairs.

Mesh Migration in to Colonic Lumen Post Abdominal Hernia Repair: A Case Report

“…Primary mechanical migration occurs when an inadequately secured mesh traverses along adjoining paths of least resistance or when a relatively secure mesh is displaced by external forces [1]. Secondary migration, on the other hand, occurs through trans-anatomical planes and is the result of erosion triggered by foreign body reaction [2]. This mechanism has been supported by the presence of inflammatory granulation tissue at the site of migration.…”

A rare cause of intestinal obstruction: dual mesh migration into the small intestine following laparoscopic umbilical hernia repair

“…In addition, migration can occur acutely or in response to an inflammatory reaction to mesh erosion over a period of years. [8][9][10] Mesh erosions into the Stomach, Small intestine, Large intestine and bladder following various hernia repairs are available in the literature.…”

Bladder Erosion and Stone as Rare Late Complication of Laparoscopic Hernia Meshplasty: Is Endoscopic Management an Option?

“…Agarwal and Avill [5] have discussed mesh migration following inguinal hernia repair and concluded such migration to be either primary mechanical migration occurring in adjoining tissue spaces along paths of least resistance or secondary migration through trans-anatomical planes due to foreign body-induced reactions.…”

“…There are no clear guidelines for the management due to rarity of presentations or under reporting. Simple cystoscopic pull out of the mesh was reported by Agarwal and Avill [5], but most patients will have a dense fibrous tissue around the mesh preventing such removal. Moreover, as the presence of mesh invokes severe inflammatory response in both genitourinary and gastrointestinal tracts, what is stuck around the mesh outside the bladder will never be known and can lead to iatrogenic bowel or ureteric complications.…”