Outcomes of Transurethral Removal of Intravesical or Intraurethral Mesh Following Midurethral Sling Surgery

PURPOSE To present outcomes of transurethral removal (TUR) of intravesical or intraurethral mesh after midurethral slings. MATERIALS AND METHODS This was a retrospective chart review of 23 consecutive women: 20 with intravesical mesh and 3 with intraurethral mesh. RESULTS To remove the mesh, transurethral resection with an electrode loop (TUR-E) was used in 16 women and transurethral resection with a holmium laser (TUR-H) was used in 7. The median follow-up was 2.1 months. Twenty-six percent of the women (6/23) had a mesh remnant: 6.2% (1/16) of the women treated with TUR-E and 71.4% (5/7) of the women treated with TUR-H. Of the 5 women treated with TUR-H, 3 underwent concomitant transvaginal removal. On the follow-up cystoscopic exam, a mesh remnant was observed in 3 women (1 treated with TUR-E and 2 treated with TUR-H). Vesico-vaginal fistulas were found in 2 women during and after TUR-E, respectively. Stress urinary incontinence recurred in 1 woman. CONCLUSIONS TUR-E has a high success rate but carries a risk of bladder perforation. Complete resection using TUR-H depends on the location of the mesh and the range of motion of the instrument.