Eroded Tape: the Case for an Early Vesicoscopy Rather Than Laser Melting

Objective To report our experience on vesicoscopic excision of eroded foreign material in the bladder. Materials and Methods The use of xenografts in female urology is becoming more prevalent and so are their complications. Erosion of foreign material into the bladder often goes unrecognized for a long time and patients are troubled by irritative urinary symptoms, recurrent infections and stone formation. The treatment of such erosions is traditionally reported through the transurethral route using LASER or electrocautery to cut the foreign material. Such methods have a high rate of incomplete material removal and as a result a high recurrence rate. Leaving a urothelial defect results in prolonged time to symptoms resolution. Between 2012 and 2015, 5 patients were referred for tertiary care to King's College Hospital and Polyclinic Ygia with eroded tapes; all patients had undergone a variety of endoscopic, vaginal and/or open attempts for mesh removal that failed. We offered vesicoscopic excision of the eroded portion of the tape. Results We here report 5 cases referred to our team with tape erosions that were treated with vesicoscopic excision of the material and primary closure of the urothelial defect. The foreign material was completely removed in all cases and there is no recurrence at a median follow-up of 30 months. Conclusion Vesicoscopic excision of bladder eroded foreign material is feasible and efficient. We recommend this technique to be considered as primary approach to tapes eroding into the bladder.