鼠径ヘルニア修復用メッシュが膀胱内に迷入した1例

Abstract

We report our experience with a case in which eroded mesh used for inguinal hernia repair migrated into the bladder. An 84-year-old man underwent surgery for colorectal cancer at the age of 40, and radical surgery for a right inguinal hernia at the age of 83. At his initial visit, he reported macroscopic hematuria. Cystoscopy revealed a yellowish-brown foreign body on the right bladder wall, and computed tomography showed the presence of emphysema in association with the foreign body. Based on a presumptive diagnosis of vesical calculi, transurethral lithotripsy was performed. However, the foreign body was strongly adherent to the bladder wall ; when lithotripsy was attempted, the calcified surface of the foreign body detached, and the exposed surface showed a mesh-like structure. Transurethral extraction was judged impossible ; therefore, laparotomy was performed at a later date to remove the foreign body, with en bloc resection including some of the bladder. The foreign body consisted of a surgical mesh that had been used for inguinal hernia repair. With the spread of surgery using surgical mesh, we should be careful about complications.