Laparoscopic Transvesical Mesh Removal and Vesicovaginal Fistula Repair

John R. Miklos, MD, Robert D. Moore, DO, Orawee Chinthakanan, MD, MPHInternational Urogynecology Associates, Alpharetta, GA, USA (all authors).

ABSTRACTBackground: Complications associated with anterior vaginal wall mesh used during transvaginal surgery for prolapse occur more frequently than in other areas of the vagina. A vesicovaginal fistula is one of the rare complications of anterior vaginal wall mesh surgery.

Case: A 69-year-old woman with a history of anterior vaginal wall prolapse developed a vesicovaginal fistula within days of undergoing anterior transvaginal mesh surgery. A transvesical laparoscopic approach was used to resect the bladder mesh. Then an extravesical vesicovaginal fistula repair was performed.

Conclusion: Laparoscopy can be an alternative to simultaneous bladder mesh removal and surgical correction of a vesicovaginal fistula.

Key Words: Vesicovaginal fistula, Mesh complications, Mesh erosion, Laparoscopic repair of vesicovaginal fistula, PROLIFT.

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