Taoka Rikiya, Mizuno Kei, Matsuoka Takashi, Kita Yuki, Nakanishi Shotaro, Asai Seiji, Soda Takeshi, Inoue Koji, Terai Akito
The Department of Urology, Kurashiki Central Hospital.
Nihon Hinyokika Gakkai Zasshi. 2011 Nov;102(6):726-30. doi: 10.5980/jpnjurol.102.726.
A 64-year-old woman presented with recto-cutaneous fistula after tension-free vaginal mesh reconstruction using polypropylene mesh for pelvic organ prolapse. Eleven months after the operation, an ulcerative lesion with stools smell secretion developed in the left hip. Magnetic resonance imaging and colonoscopy revealed a migration of the left arm of the mesh and a recto-cutaneous fistula. The patient underwent excision of the infected mesh and rectal wall closure together with transient colostomy. After 8 months, colonoscopy revealed a new migration of the mesh in the rectum, which was also removed. The colostomy was closed one year later and rectal erosion has not reccurred since then. The possibility of developing a rare but severe mesh-related complication as presented here should always be kept in mind.
一名64岁女性在使用聚丙烯网片进行盆腔器官脱垂的无张力阴道网片重建术后出现直肠皮肤瘘。术后11个月，左髋部出现一个有粪便样分泌物的溃疡性病变。磁共振成像和结肠镜检查显示网片左臂移位及直肠皮肤瘘。患者接受了感染网片切除、直肠壁闭合及临时结肠造口术。8个月后，结肠镜检查发现网片在直肠内再次移位，也将其切除。1年后结肠造口关闭，此后直肠侵蚀未再复发。应始终牢记出现本文所述这种罕见但严重的网片相关并发症的可能性。
