Role of endoscopic management in synthetic sling/mesh erosion following previous incontinence surgery: a systematic review from European Association of Urologists Young Academic Urologists (YAU) and Uro-technology (ESUT) groups

Autor: Vincent De Coninck, Panagiotis Kallidonis, Andreas Skolarikos, Amelia Pietropaolo, Thomas Tailly, Etienne Xavier Keller, Bhaskar K. Somani, Omar M. Aboumarzouk, Sulaiman Sadaf Karim
Přispěvatelé: University of Zurich, Somani, Bhaskar Kumar
Rok vydání: 2019
Předmět:
Sling (implant)
030232 urology & nephrology
Urinary incontinence
Review Article
TVT
0302 clinical medicine
Gynecologic Surgical Procedures
Postoperative Complications
Sling
Medicine
030219 obstetrics & reproductive medicine
medicine.diagnostic_test
Obstetrics and Gynecology
Middle Aged
Foreign Bodies
3. Good health
Treatment Outcome
Tape
Endoscopic
TOT
Female
medicine.symptom
2748 Urology
Adult
medicine.medical_specialty
Urology
Laser
610 Medicine & health
Endoscopic management
03 medical and health sciences
Mesh erosion
Humans
Device Removal
Aged
Mesh
Suburethral Slings
Incontinence
business.industry
2729 Obstetrics and Gynecology
Endoscopy
Surgical Mesh
medicine.disease
Endoscopic removal
Surgery
10062 Urological Clinic
Neck of urinary bladder
Urinary Incontinence
Laparoscopy
Foreign body
business
Complication
Zdroj: International Urogynecology Journal
ISSN: 1433-3023
Popis: Introduction and hypothesis Foreign body (FB) erosion is now recognized as a major long-term complication following previous incontinence surgery. The aim of our systematic review was to ascertain the outcomes of endoscopic management in synthetic sling/mesh erosion following previous gynaecological surgery. Methods A systematic review in line with PRISMA and Cochrane guidelines was conducted for all English language articles between 1996 and December 2018 for all articles reporting on endoscopic surgical management for eroded FB following previous sling/mesh procedure for incontinence. Results Our search produced 931 articles of which 20 articles (198 patients) were included in our review; 149 (75%) had tension-free vaginal tapes (TVT) or tension-free obturator tapes (TOT) as their initial procedure. The site of mesh erosion was the bladder in 134 patients (68%) of which 12 (6%) were in the bladder neck. Urethral mesh erosion was seen in 63 patients (32%) across all studies. The treatment of eroded mesh was by laser and endoscopic excision using an electrode loop or laparoscopic scissors in 108 (55%) and 90 (45%) patients respectively. The initial/final success rate with laser and endoscopic excision was 67%/92% and 80%/98% respectively. The overall complication rates were 24% and 28% in laser and endoscopic groups respectively of which 21% in each group were stress urinary incontinence. Conclusions Endoscopic management of FB erosion is an effective minimally invasive technique with good outcomes and minimal morbidity. Management with the use of holmium laser is gaining momentum and could be attempted before open surgical removal. There is a need for comparative data between open surgical excision and endoscopic excision to help better describe the patient’s most likely to benefit from the endoscopic technique.
Databáze: OpenAIRE
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