Vaginal and laparoscopic sub-urethral sling explantation.
Int Urogynecol J
; 34(6): 1329-1331, 2023 06.
Article
en En
| MEDLINE
| ID: mdl-36905410
ABSTRACT
INTRODUCTION AND HYPOTHESIS:
The objective was to describe the different laparoscopic and vaginal steps of sub-urethral infected mesh explantation as well as an unexpected and unusual complication a sub-mucosal calcification on the sub-urethral segment of the sling that was not infiltrating the urethra.METHODS:
This was carried out at our University Teaching Hospital of Strasbourg.RESULTS:
We show the complete removal of an infected retropubic sling in a patient who had already undergone three previous surgeries without resolution of symptoms. This is a difficult case requiring a laparoscopic approach of the space of Retzius, which has been less familiar to surgeons since the advent of the midurethral sling. We show how to approach this space in an inflammatory environment by specifying its anatomical limits. Moreover, a great deal can be learned from the occurrence of an infectious complication after the surgery and the presence of a large calcification on the prosthesis. In this context, we advise a systematic antibiotic treatment to avoid this kind of complication.CONCLUSIONS:
Knowing the guidelines and the different surgical steps will help urogynecological surgeons to perform similar procedures in patients requiring removal of retropubic slings for complications such as infection and pain, where conservative management has not been successful. These cases must be discussed in a multidisciplinary meeting, as recommended by the French National Authority for Health, and managed in an expert establishment.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Incontinencia Urinaria de Esfuerzo
/
Laparoscopía
/
Cabestrillo Suburetral
Tipo de estudio:
Guideline
Límite:
Female
/
Humans
Idioma:
En
Revista:
Int Urogynecol J
Asunto de la revista:
GINECOLOGIA
/
UROLOGIA
Año:
2023
Tipo del documento:
Article
País de afiliación:
Francia