A 73-year-old patient with a history of uterine carcinoma treated by hysterectomy with double adnexectomy and external radiotherapy in 2000.
In 2002, she was diagnosed with urinary incontinence of mixed origin and treated by placing a TVT mesh.
At 6 months and with the persistence of incontinence, a new intervention was performed by placing a new TVT mesh.
The patient was referred to our service on August 9, 2006 with an intense clinical presentation of dysuria, perineal pain, emergency room, urge incontinence, urinary incontinence requiring the use of three diapers constitutional syndrome yearly.
A bladder ultrasound was performed observing the presence of a hyperechogenic image attached to the bladder wall.
Given the existence of digestive symptoms presented by the patient, we requested an MRI for evaluation of possible stenosis, which showed the existence of an intravesical filling defect of approximately 3 cm compatible with a subtral bladder calculus and mesh.
Subsequently, a simple abdominal X-ray was performed for control, including pubis, which showed the presence of lithiasis in the lateral wall - bladder neck.
A suprapubic cystolithotomy was performed.
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Under general anesthesia an infraumbilical midline incision was performed.
After the release of multiple perivesical adhesions, the bladder dome was opened, finding the calculus attached to the wall using a visible mesh segment in the intravesical space.
After sectioning the intravesical segment of the mesh, the calculus was extracted and the cystostomy was closed.
On the 5th postoperative day, drainage was removed and the patient was discharged with a urinary catheter and removed after 15 days.
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In subsequent reviews, discomfort, dysuria and perineal pain were completely resolved.
Urinary incontinence persists but improves with respect to the previous situation since it requires only one or two pads a day.
