Outcomes of transurethral removal of intravesical or intraurethral mesh following midurethral sling surgery.

Purpose: To present outcomes of transurethral removal (TUR) of intravesical or intraurethral mesh after midurethral slings.
Materials and Methods: This was a retrospective chart review of 23 consecutive women: 20 with intravesical mesh and 3 with intraurethral mesh.
Results: To remove the mesh, transurethral resection with an electrode loop (TUR-E) was used in 16 women and transurethral resection with a holmium laser (TUR-H) was used in 7. The median follow-up was 2.1 months. Twenty-six percent of the women (6/23) had a mesh remnant: 6.2% (1/16) of the women treated with TUR-E and 71.4% (5/7) of the women treated with TUR-H. Of the 5 women treated with TUR-H, 3 underwent concomitant transvaginal removal. On the follow-up cystoscopic exam, a mesh remnant was observed in 3 women (1 treated with TUR-E and 2 treated with TUR-H). Vesico-vaginal fistulas were found in 2 women during and after TUR-E, respectively. Stress urinary incontinence recurred in 1 woman.
Conclusions: TUR-E has a high success rate but carries a risk of bladder perforation. Complete resection using TUR-H depends on the location of the mesh and the range of motion of the instrument.