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Case report
Endoscopic holmium laser fragmentation and retrieval of migrated intravesical prolene mesh
  1. Rohit Dadhwal1,
  2. Sanjay Kumar2,3,
  3. Prem Nath Dogra1 and
  4. Sridhar Panaiyadiyan1
  1. 1Urology, All India Institute of Medical Sciences, New Delhi, Delhi, India
  2. 2Urology, SMS Medical College and Attached Hospital, Jaipur, Rajasthan, India
  3. 3Surgery, All India Institute of Medical Sciences, New Delhi, Delhi, India
  1. Correspondence to Dr Sanjay Kumar; sankum10{at}yahoo.co.in

Abstract

A 52-year-old man presented with lower urinary tract symptoms and intermittent haematuria for the last 6 months. He had undergone totally extraperitoneal right inguinal hernia repair a decade ago. The ultrasonography and an X-ray of the pelvis suggested a large radio-opaque shadow in the bladder. However, CT revealed an encrusted intravesical extension of the migrated mesh along the right anterolateral wall. The entire intravesical part of the migrated mesh with encrustations was successfully retrieved by endourological approach using holmium laser. The patient symptomatically improved and at follow-up, cystoscopy showed a complete re-epithelisation of the bladder mucosa. The intravesical extension of migrated mesh is a rare but challenging complication following mesh hernioplasty and can be successfully managed with a complete endoscopic approach.

  • urology
  • haematuria

https://doi.org/10.1136/bcr-2020-236987

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    Footnotes

    • Contributors RD did initial work-up of the patient and was involved in the follow-up. SK operated on the patient. PND was in charge of the overall work. SP was also involved in postoperative management. All the authors contributed to the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.