Steinberg Benjamin J, Mapp Tiffany, Mama Saifuddin, Echols Karolynn T
Cooper University Hospitals, Division of Female Pelvic Medicine and Reconstructive Surgery, Camden, NJ, USA.
JSLS. 2012 Jul-Sep;16(3):488-91. doi: 10.4293/108680812X13462882736619.
There have been many reports in the literature on vaginal mesh erosion as a complication of pelvic floor reconstructive surgery. Several reports describe successful surgical excision of the exposed mesh as a resolution. However, in rare cases of mesh erosion, poor surgical outcomes and multiple resection failures have been reported. We describe an innovative surgical approach to persistent vaginal mesh erosion using CO(2) laser vaporization under colposcopic and laparoscopic guidance.
A 58-y-old postmenopausal woman first presented with a 3-y history of vaginal discharge and spotting after undergoing a Mentor ObTape transobturator sling (Mentor Corp, Santa Barbara, CA), for the treatment of stress urinary incontinence. Despite surgical removal of the mesh and multiple attempts at cauterization of persistent granulation tissue, her symptoms persisted.
Using a CO(2) laser under colposcopic and laparoscopic guidance, we were able to safely expose and remove the remaining portion of retained mesh. To our knowledge, this is the first report describing CO(2) laser vaporization as a surgical approach for the successful treatment of recurrent mesh erosion.
文献中有许多关于阴道网片侵蚀作为盆底重建手术并发症的报道。一些报道描述了成功手术切除暴露的网片作为一种解决方法。然而，在罕见的网片侵蚀病例中，已有手术效果不佳和多次切除失败的报道。我们描述了一种在阴道镜和腹腔镜引导下使用二氧化碳激光汽化治疗持续性阴道网片侵蚀的创新手术方法。
一名58岁绝经后女性，在接受Mentor ObTape经闭孔吊带（Mentor公司，加利福尼亚州圣巴巴拉）治疗压力性尿失禁3年后，首次出现阴道分泌物和点滴出血的症状。尽管手术切除了网片并多次尝试烧灼持续性肉芽组织，但其症状仍持续存在。
在阴道镜和腹腔镜引导下使用二氧化碳激光，我们能够安全地暴露并切除残留网片的剩余部分。据我们所知，这是第一份将二氧化碳激光汽化作为成功治疗复发性网片侵蚀的手术方法的报告。
