Rectal mesh erosion after posterior vaginal kit repair
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Introduction and hypothesis
The present video shows a rare case of erosion through the full rectal wall into the rectum after a transperineal implant of a double-arm polypropylene kit.
A 70-year-old woman underwent a transperineal implant of a double-arm polypropylene kit. One year after surgery, she developed bothersome symptoms in the posterior perineum including heaviness, pain and rectal bleeding during defecation. A clinical examination showed the presence of a part of the prothesis traversing the rectal cavity. A minimally invasive transanal approach was performed to remove the mesh and restore the rectal integrity.
This surgical technique demonstrates rectal mesh removal with a transanal approach.
To our knowledge, this is a rare complication of rectal erosion of a posterior transperineal mesh kit. The aim of this video is to show a complete transanal approach to treating this serious complication avoiding the more invasive and traumatic abdominal procedure.
KeywordsRectal mesh erosion Pelvic organ prolapse Vaginal kit Transanal approach
Compliance with ethical standards
Conflicts of interest
(MP4 91,880 kb)
- 1.Lisi G, Campanelli M, Grande S, Grande M, Mascagni D, Milito G. Transperineal rectocele repair with biomesh: updating of a tertiary refer center prospective study. Int J Color Dis. 2018. https://doi.org/10.1007/s00384-018-3054-2.
- 3.FDA Public Health Notification: Serious Complications Associated with Transvaginal Placement of Surgical Mesh in Repair of Pelvic Organ Prolapse and Stress Urinary Incontinence (2008) http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/PublicHealthNotifications/ucm061976.htm.
- 4.FDA Safety Communication: UPDATE on Serious Complications Associated with Transvaginal Placement of Surgical Mesh for Pelvic Organ Prolapse (2011) http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm262435.htm.
- 5.Haylen BT, Freeman RM, Swift SE, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint terminology and classification of complications related directly to the insertion of prostheses (meshes, implants, tapes) and grafts in female pelvic floor surgery. Int Urogynecol J. 2011;22:3–15 Neurourology and Urodynamics 30(1):2-12.CrossRefPubMedGoogle Scholar
- 6.Surgery for women with posterior compartment prolapse (Review) Cochrane Database of Systematic Reviews. 2018, Issue 3. CD012975. https://doi.org/10.1002/14651858.CD012975.
- 8.Zhang L, Zhu L, Xu T, Liang S, Lang J. Postoperative voiding difficulty and mesh-related complications after total prolift system surgical repair for pelvic organ prolapse and predisposing factors. Menopause J North Am Menopause Soc. 22(8):885–92. https://doi.org/10.1097/gme.0000000000000402*2015.
- 9.Lang P, Oliphant S, Mizell J, Austin B, Barr S. Rectal perforation at the time of vaginal mesh placement and subsequent abdominal mesh removal. Int Urogynecol J. 2015.Google Scholar
- 10.Guenin MO, Wolfisberg L, Kern B, Stoll L, Borbély Y, von Flüe M. Service de Chirurgie Viscérale, St- Claraspital, Basel, Suisse. Érosion rectale d’une prothèse pour cure de prolapsus vaginal (Prolift). January JOGC JANVIER. 2011.Google Scholar