Ruanphoo Purim, Nomura Jimmy, Hayashi Tokumasa, Tokiwa Shino, Nagae Mika, Soliza Divina, Pesebre Antonette, Ayumba Albert, Kaneko Hisao
Department of Urogynecology, Kameda Medical Center, Chiba, Japan.
Gynecol Minim Invasive Ther. 2025 Apr 24;14(3):259-263. doi: 10.4103/gmit.gmit_86_24. eCollection 2025 Jul-Sep.
We present the management of seven patients who were diagnosed with bladder stone associated with exposed intravesical mesh after transvaginal mesh (TVM) surgery for pelvic organ prolapse. The TVM may be exposed inside the bladder which can result in urinary stone formation. Several treatment modalities have been proposed such as laser lithotripsy, transurethral resection, and open or laparoscopic resection of exposed mesh. However, the optimal route of treatment remains inconclusive. In our series, two cases were managed by transurethral resection and one of them had recurrence. Five cases were managed by laparoscopic resection and one of them had recurrence. Two recurrent cases underwent laparoscopic resection and then no recurrence occurred. No intraoperative or postoperative complications occurred. Although there is limited evidence, we recommend laparoscopic resection for the treatment of intravesical mesh exposure. Offering transurethral resection as an initial management of intravesical mesh exposure is possible with careful discussion about the recurrence rate.
我们介绍了7例盆腔器官脱垂经阴道网片（TVM）手术后被诊断为膀胱结石合并膀胱内网片暴露患者的治疗情况。TVM可能暴露于膀胱内，这会导致尿路结石形成。已经提出了几种治疗方式，如激光碎石术、经尿道切除术以及开放或腹腔镜下切除暴露的网片。然而，最佳治疗途径仍无定论。在我们的病例系列中，2例采用经尿道切除术治疗，其中1例复发。5例采用腹腔镜切除术治疗，其中1例复发。2例复发病例接受了腹腔镜切除术，之后未再复发。未发生术中或术后并发症。尽管证据有限，但我们建议采用腹腔镜切除术治疗膀胱内网片暴露。在仔细讨论复发率的情况下，将经尿道切除术作为膀胱内网片暴露的初始治疗方法也是可行的。
