title: Endoscopic lithotripsy and vaginal excision of a calcified bladder-mesh extrusion.
abstract: OBJECTIVE
  Synthetic meshes have proven to increase efficacy of pelvic organ prolapse (POP) repair, but associated complications are not rare. Bladder mesh extrusion is one of the most serious adverse events following POP surgery with mesh. The aim of this video was to describe endoscopic and vaginal approaches for treating a bladder-mesh extrusion.
  
  
  METHODS
  A 52-year-old female patient with a history of vaginal POP surgery with mesh was referred for severe pelvic and perineal pain, dyspareunia, and dysuria. She was found to have a bladder calculus on a mesh extrusion. The calculus was removed by endoscopic lithotripsy before vaginal mesh excision was performed.
  
  
  CONCLUSIONS
  With the use of synthetic vaginal mesh, the incidence of bladder-mesh extrusion could increase. This didactic video will be helpful to surgeons required to manage such cases using a minimally invasive treatment.
authors.affiliation: Pôle Mère-Femme, Besancon University Medical Centre, 3 Alexander Fleming boulevard, 25030, Besançon, France.
authors.forename: H Joaquín
authors.initials: HJ
authors.lastname: Alvarez Garzon
authors.affiliation: Urology Department, Besancon University Medical Centre, Besancon, France.
authors.forename: Baptiste
authors.initials: B
authors.lastname: Jacquemet
authors.affiliation: Pôle Mère-Femme, Besancon University Medical Centre, 3 Alexander Fleming boulevard, 25030, Besançon, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Mottet
authors.affiliation: Urology Department, Besancon University Medical Centre, Besancon, France.
authors.forename: François
authors.initials: F
authors.lastname: Kleinclauss
authors.affiliation: Pôle Mère-Femme, Besancon University Medical Centre, 3 Alexander Fleming boulevard, 25030, Besançon, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Riethmuller
authors.affiliation: Pôle Mère-Femme, Besancon University Medical Centre, 3 Alexander Fleming boulevard, 25030, Besançon, France. rajeev.ramanah@univ-fcomte.fr.
authors.forename: Rajeev
authors.initials: R
authors.lastname: Ramanah
mesh_terms: D020878:Device Removal; D004724:Endoscopy / Q000379:methods*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D008096:Lithotripsy / Q000379:methods*; D008875:Middle Aged; D013526:Surgical Mesh / Q000009:adverse effects*; D001744:Urinary Bladder Calculi / Q000209:etiology / Q000628:therapy*
keywords: Bladder extrusion; Intravesical mesh; Mesh complication; Pelvic organ prolapse; Pneumatic lithotripsy; Urinary bladder calculi