Bodenbach M, Bschleipfer T, Stoschek M, Beckert R, Sparwasser C
Urologische Abteilung, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081 Ulm.
Urologe A. 2002 Jul;41(4):366-8. doi: 10.1007/s00120-001-0148-0.
The repair of an inguinal hernia is the surgical procedure most often performed. Complication rates after laparoscopic hernioplasty amount up to 19%, with hematoma/seroma, neuralgia, urinary retention, and chronic pain most frequently reported. Significant complications such as trocar site bleeding or bowel injury occur in 0.4-5.6%, and sporadic intraoperative lesions of the bladder have been mentioned. We present a 48-year-old patient with recurrent dysuria 3 years after transabdominal preperitoneal hernioplasty (TAPP). The preoperative diagnostic evaluation led to the assumption of an intravesical mesh dislocation. In spite of extensive adhesions between the mesh and the bladder wall, the mesh including five fixation coils could be removed via a suprapubic access. The postoperative period was without complications, and the patient has no complaints. The incidence of complications after laparoscopic hernioplasty is low. Still, severe problems such as mesh rejection, spermatic granuloma, or mesh migration into the small and large intestine do occur. Migration of a mesh into the urinary bladder has only been described twice.
腹股沟疝修补术是最常施行的外科手术。腹腔镜疝修补术后的并发症发生率高达19%,最常报告的是血肿/血清肿、神经痛、尿潴留和慢性疼痛。严重并发症如套管针部位出血或肠损伤的发生率为0.4 - 5.6%,并且有零星的术中膀胱损伤的报道。我们报告一名48岁患者,在经腹腹膜前疝修补术(TAPP)3年后出现复发性排尿困难。术前诊断评估推测为膀胱内补片移位。尽管补片与膀胱壁之间存在广泛粘连,但通过耻骨上入路仍可取出包含五个固定线圈的补片。术后无并发症,患者无不适主诉。腹腔镜疝修补术后并发症的发生率较低。不过,确实会出现诸如补片排斥、精索肉芽肿或补片迁移至小肠和大肠等严重问题。补片迁移至膀胱仅被描述过两次。