Complications after laparoscopic burch with hernia mesh and surgical tacks.
BACKGROUND
The Burch retropubic urethropexy for the repair of stress urinary incontinence can be performed laparoscopically. Advances in laparoscopic technique have led some surgeons to perform this procedure with hernia mesh and surgical tacks.


METHODS
A postmenopausal woman presented with complaints of lower abdominal pain, dyspareunia, dysuria, and urinary urgency and frequency after a laparoscopic Burch and paravaginal repair. Bimanual examination revealed tenderness over the pelvic floor muscles and anterior vaginal wall. Exploratory laparotomy revealed dense fibrous adhesions in the space of Retzius along with mesh, permanent suture, and 13 helical tacks.


CONCLUSIONS
Laparoscopic procedures that use hernia mesh fastened with surgical tacks should not be used in the vagina or surrounding structures.
Albright
Todd S
TS
Department of Obstetrics and Gynecology, Washington Hospital Center, Washington, DC, USA. Todd.albright@amedd.army.mil
Garlich
Caro L
CL
Iglesia
Cheryl B
CB
D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008875:Middle Aged; D017773:Pelvic Floor; D011183:Postoperative Complications; D013526:Surgical Mesh; D013537:Sutures; D000267:Tissue Adhesions / Q000209:etiology*; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods