Presentation Authors: Dominique Thomas, Mitali Kini*, Tirsit Asfaw, Bilal Chughtai, New York, NY
Introduction: The purpose of this study was to determine the safety and efficacy of different outcomes used in surgical excision of bladder and urethral mesh erosions.
Methods: A systematic review was compiled after searching electronic databases (PUBMED and MEDLINE) for clinical studies involving combined outcomes for mesh erosion in humans. Databases were searched from the time of inception through May 2016 for articles reporting surgical techniques to remove eroded mesh. Key terms searched were : â€œmesh erosion in bladderâ€, â€œmanagement of bladder mesh erosionsâ€, "bladder mesh erosionsâ€, "management of mesh erosions", "mesh erosion into the bladder", "mesh erosions of the bladder", "management of mesh erosions in the bladder", "mesh erosions", "bladder erosions due to mesh", â€œurethral erosionâ€, and "transurethral resection of bladder erosionâ€.
Results: A total of 754 articles were found, 654 articles were excluded due to ineligibility criteria. A total of 100 articles were included in our systematic review, with total of 177 patients analyzed. Of the patients who underwent mesh removal 18 were abdominal, 40 were transvaginal, 119 were cystoscopic mesh removal. For these techniques the percentage of patients who felt their symptoms were resolved compared to those unresolved were abdominal (78% vs. 22%); transvaginal (63% vs. 37%) and cystoscopic bladder (55% vs. 44%) and cystoscopic urethra (39% vs. 22%). Mesh removal was successful 85% in abdominal, 100% in transvaginal, 83% in endoscopy/cystoscopy and 85% in cystoscopy bladder.
Conclusions: The abdominal and transvaginal approach to mesh removal appeared to have greater success at removing mesh then the cystoscopic approaches. For mesh eroded into the urethra, a transvaginal approach had better resolution of symptoms and less intervention. For mesh eroded into the bladder, abdominal and cystoscopic approaches for bladder mesh erosion had similar symptom resolution but abdominal approach required less retreatment.
Source of Funding: N/A