Liu Wan-Zhang, Qian Jun-Hai, Shen Zhi-Jiu, Yang Bin-Bin, Cheng Yue
Department of Urology, Ningbo City First Hospital, the Affiliated Hospital of Ningbo University, #59 Liuting Street, Ningbo, 315010, Zhejiang Province, China.
BMC Surg. 2020 Jul 21;20(1):161. doi: 10.1186/s12893-020-00818-4.
Hernia mesh erosion into the urinary bladder is a rare complication of hernioplasty, and mesh immigration is the most probable pathophysiology. There is no report describing mesh erosion induced by fixing tacks in inguinal hernia repair.
A 37-year-old man was admitted to our hospital with frequency, urgency and odynuria for 3 months. He received open right inguinal hernia repair in September 2014, and right laparoscopic hernioplasty for recurrence of the inguinal hernia in May 2015. In February 2019, he underwent a day-case transurethral cystoscopic operation for urethral and bladder stones. Cystoscopy revealed the existence of bladder stones and part of the eroded mesh on the right anterior wall, for which an open partial cystectomy was performed. The patient was followed up for 3 months postoperatively, during which no further mesh erosion or stone recurrence was detected by cystoscopy.
This is the first case report describing mesh erosion into the urinary bladder by fixing tacks following laparoscopic inguinal hernia repair. In such a case, the eroded mesh and tacks need to be removed completely, but the effectiveness of a single transurethral procedure needs to be verified in more cases.
疝修补网片侵蚀膀胱是疝修补术一种罕见的并发症,网片移位是最可能的病理生理机制。尚无关于腹股沟疝修补术中固定钉导致网片侵蚀的报道。
一名37岁男性因尿频、尿急和尿痛3个月入院。他于2014年9月接受了开放性右侧腹股沟疝修补术,并于2015年5月因腹股沟疝复发接受了右侧腹腔镜疝修补术。2019年2月,他因尿道和膀胱结石接受了日间经尿道膀胱镜手术。膀胱镜检查发现膀胱结石及右侧前壁部分侵蚀的网片,为此进行了开放性部分膀胱切除术。患者术后随访3个月,在此期间膀胱镜检查未发现进一步的网片侵蚀或结石复发。
这是首例描述腹腔镜腹股沟疝修补术后固定钉导致网片侵蚀膀胱的病例报告。在这种情况下,需要彻底清除侵蚀的网片和固定钉,但单一经尿道手术的有效性需要更多病例进行验证。