ASST Monza, San Gerardo Hospital, Monza, Italy.
ASST Santi Paolo e Carlo, University Hospital San Paolo, Milano, Italy.
Int Urogynecol J. 2020 Apr;31(4):843-845. doi: 10.1007/s00192-020-04261-0. Epub 2020 Mar 5.
Mesh-augmented lateral suspension for prolapse repair seems to be associated with few complications. However, mesh-related complications can negatively affect the quality of life and may be challenging to manage. This video is aimed at presenting the surgical management of a case of severe pelvic pain and dyspareunia after lateral laparoscopic suspension associated with mesh erosion in the bladder.
A 46-year-old woman was referred to our Unit for severe pelvic pain and inability to have sexual intercourses since undergoing a uterus-sparing laparoscopic lateral suspension procedure for genital prolapse 2 years before in another hospital. Moreover, she reported bladder pain and recurrent urinary tract infections. Cystoscopy showed mesh erosion in the bladder. She was admitted to laparoscopic hysterectomy plus subtotal mesh excision and bladder reconstruction (video).
No surgical complications were observed. The postoperative course was uneventful. At the current follow-up, the patient reported complete resolution of her symptoms.
The featured video shows laparoscopic subtotal mesh excision, concomitant hysterectomy and bladder repair for pelvic pain, dyspareunia and bladder erosion after lateral suspension. This video may be useful in providing anatomical views and surgical steps necessary for achieving successful surgical management of this mesh-related complication.
用于脱垂修复的网片增强侧方悬吊术似乎与较少的并发症相关。然而，与网片相关的并发症可能会对生活质量产生负面影响，并且可能难以处理。本视频旨在介绍一例与网片侵蚀相关的膀胱侧腹腔镜悬吊术后发生严重盆腔痛和性交困难的病例的手术处理方法。
一名 46 岁女性因在另一家医院接受子宫保留腹腔镜侧方悬吊术治疗生殖道脱垂 2 年后出现严重盆腔痛和无法进行性交而被转诊至我科。此外，她还报告有膀胱疼痛和反复尿路感染。膀胱镜检查显示网片侵蚀膀胱。她接受了腹腔镜子宫切除术加部分网片切除术和膀胱重建术（视频）。
未观察到手术并发症。术后过程顺利。在目前的随访中，患者报告其症状完全缓解。
本视频介绍了腹腔镜下部分网片切除术、同期子宫切除术和膀胱修补术，用于治疗侧方悬吊术后的盆腔痛、性交困难和膀胱侵蚀。本视频可能有助于提供必要的解剖视图和手术步骤，以成功处理这种与网片相关的并发症。
