V01-04 adjustable Autologous Sling: A Feasible Solution for a Complex Mesh Complication

Abstract

via transvaginal approach.RESULTS: Rigid cystoscopy reveals a wide portion of exposed mesh within the midurethra. An inverted U-shape incision overlying the anterior vaginal wall is performed using sharp and blunt dissection. The periurethral pockets are dissected bilaterally in the expected trajectory of the sling arms. An additional flap of anterior vaginal tissue is created. The urethra is identified and opened sharply. The segment of perforated urethral mesh is identified. A right-angle clamp is passed to isolate the urethral mesh for incision. The cut edges are grasped and dissected off the urethral wall laterally for bilateral excision. A urethroplasty is performed with interrupted 4-0 Vicryl. The catheter is repositioned at the meatus and backfilled to confirm a watertight anastomosis. The periurethral tissue is reapproximated overlying the repair. The vaginal epithelium is then closed. Final cystoscopy confirms no residual mesh and a normal caliber urethra following repair.CONCLUSIONS: Transvaginal excision of perforated synthetic sling involving the urethra allows for complete removal from the urinary tract. At 1-month postoperative follow-up, the patient reported reduced urgency and no urinary tract infections.