Migration of endotacker into the bladder 7 years after laparoscopic retroperitoneal Burch application

Abstract

Laparoscopy began to be used widely since the second half of 1990s as an alternative to laparotomy or vaginal approaches in incontinence and pelvic diseases in women, based on its claimed better success rates. Injuries were reported in the bladder, gastrointestinal system and the entry of the Verress cannula in early and late laparoscopic applications. De-novo urging, voiding dysfunctions, marked recurrences and surgical inefficiencies were observed in 5-year follow-ups after laparoscopic incontinence surgery. Although tension-free midurethral sling operations replaced open laparoscopic colposuspensions nowadays, laparoscopic colposuspension is still preferred in cases where simultaneous laparoscopic paravaginal repair or sacrocolpopexy is considered or where synthetic graft implantation is contraindicated. Moreover, meshes and endotackers are still frequently used in many laparoscopic applications in various clinics. The migration of the tacker used in mesh fixation in a patient where retroperitoneal laparoscopic Burch was performed 7 years ago due to stress urinary incontinence and the extraction of the ossified tacker from the bladder will be presented.

Figure 1a. Ultrasonography image of bladder stone.

Figure 1b. Tomography (CT) image of endotacker inside the bladder.

Figure 1c. CT image of normally localized endotackers.

Figure 1d. CT image of endotacker migrated behind the bladder.

Figure 2. Migrated tacker adhered on the bladder wall at cystoscopy and post-surgery images.