title: Cystoscopic removal of intravesical synthetic mesh extrusion  with the aid of Endoloop sutures and endoscopic scissors.
abstract: Synthetic mesh is commonly used in urogynecologic surgical procedures for correction of stress urinary incontinence and pelvic organ prolapse. Bladder mesh extrusion is a recognized complication and frequently requires extensive mesh resection. We present a case of intravesical polypropylene mesh extrusion following a combined mesh kit and midurethral sling placement. A novel transurethral approach, employing Endoloop sutures with endoscopic scissors, was used to resect the protruding mesh located in close proximity to a ureteral orifice. Medline was searched for other minimally invasive treatment strategies for bladder mesh extrusion. Various techniques for minimally invasive resection of extruded intravesical mesh have been described in the literature. Our strictly transurethral approach avoids the use of an energy source and eliminates the need for open or extensive surgery. Advantages of this new transurethral operative technique include decreased risk of injury associated with the use of an energy source within the bladder and avoidance of open surgical complications.
authors.affiliation: Department of Urology, Geisinger Medical Center, Danville, PA, USA. jmbieniek@geisinger.edu
authors.forename: Jared M
authors.initials: JM
authors.lastname: Bieniek
authors.forename: Tara L
authors.initials: TL
authors.lastname: Holste
authors.forename: Raisa O
authors.initials: RO
authors.lastname: Platte
authors.forename: Vatche A
authors.initials: VA
authors.lastname: Minassian
mesh_terms: D003558:Cystoscopy / Q000379:methods*; D020878:Device Removal / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery; D053825:Suburethral Slings / Q000009:adverse effects*; D013526:Surgical Mesh / Q000009:adverse effects*; D013536:Suture Techniques; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000601:surgery