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Endoscopic Transurethral Resection of Urethral Mesh Erosion With the Use of a Pediatric Nasal Speculum

Plowright, Leon N. MD; Duggal, Balpreet MD; Aguilar, Vivian C. MD; Davila, G. Willy MD

doi: http://10.1097/AOG.0b013e31827ee037
Case Report
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BACKGROUND: A rare but challenging complication of midurethral slings is erosion of mesh tape through the urethral wall.

CASES: In this report, we describe two cases in which a pediatric nasal speculum provided exposure for transurethral resection of eroded mesh. Exposure was sufficient for complete mesh resection endoscopically as well as with use of traditional surgical instruments. Since having surgery there has been no recurrence of mesh erosion and the irritative voiding symptoms have resolved.

CONCLUSION: Urethral mesh erosion can be managed from a transurethral approach. Furthermore, use of a pediatric nasal speculum improves visualization and efficiency.

Using a pediatric nasal speculum provides the needed exposure for ease of endoscopic resection of eroded urethral mesh.

Section of Urogynecology and Reconstructive Pelvic Surgery, Department of Gynecology, Cleveland Clinic Florida, Weston, Florida; and the Department of Obstetrics and Gynecology, San Fernando General Hospital, San Fernando, Trinidad and Tobago, West Indies.

Corresponding author: G. Willy Davila, MD, 2950 Cleveland Clinic Boulevard, Weston, FL 33331; e-mail: davilag@ccf.org.

Financial Disclosure Dr. Davila has been a consultant and speaker for and received honoraria from Astellas and CL Medical. He has been a speaker and consultant for and received honoraria and royalties from American Medical Systems. He also has been a speaker for and received honoraria from Warner-Chilcott. The other authors did not report any potential conflicts of interest.

© 2013 The American College of Obstetricians and Gynecologists