At times it seems that surgeons are removing more mesh than placing it today. Davis et al (page 1828) from Ireland describe a relatively easy and straightforward way of initially managing mesh erosion into the bladder and urethra before attempting open surgery using a holmium:YAG laser for endoscopic excision.1 Only 1 of 12 women subsequently required open cystotomy to remove the eroded biomaterial. The authors describe their technique in detail which includes cystourethros-copy and in some cases a stent grasper to position and vaporize the mesh material. It appears that endoscopic laser excision to melt the mesh may be a potential first line approach for managing eroded material based on long-term success and morbidity.
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