Lower Urinary Tract Mesh Perforations following the Insertion of Mid-urethral Tapes or Transvaginal Mesh: A Tertiary Unit’s Experience

Abstract

Mesh perforation of the urinary-tract is a rare complication of midurethral tapes for stress urinary incontinence (SUI), and transvaginal mesh for pelvic organ prolapse (POP). We review the outcomes of women presenting to our tertiary service. This retrospective review identifies patients presenting to our unit between January 2011 June 2017. We identified 40 women. Twenty-three had perforation from SUI tapes, 10 following POP mesh, and 7 had both. All underwent surgical management. Seven reported being cured, 24 reported improvement, 6 reported no change and 2 reported worsening symptoms. Seventeen developed worsening post-operative SUI. Ten opted for surgical management. Four had autologous fascial sling (AFS), 4 had bladder neck injections and 2 had colposuspension. Two patients reported recurrence in POP. One was treated successfully with physiotherapy and the other with a sacrocolpopexy. Treatment of mesh perforation is a complex process. As part of a specialised MDT, complications can be minimised.