Intravesical migration of a polypropylene mesh 3 years after laparoscopic transperitoneal hernioplasty

The repair of an inguinal hernia is the surgical procedure most often performed. Complication rates after laparoscopic hemioplasty amount up to 19%, with hematoma/seroma, neuralgia, urinary retention,and chronic pain most frequently reported. Significant complications such as trocar site bleeding or bowel injury occur in 0.4-5.6%, and sporadic intraoperative lesions of the bladder have been mentioned. We present a 48-year-old patient with recurrent dysuria 3 years after transabdominal preperitoneal hemioplasty (TAPP). The preoperative diagnostic evaluation led to the assumption of an intravesical mesh dislocation. In spite of extensive adhesions between the mesh and the bladder wall,the mesh including five fixation coils could be removed via a suprapubic access. The postoperative period was without complications, and the patient has no complaints. The incidence of complications after laparoscopic hemioplasty is low. Still, severe problems such as mesh rejection, spermatic granuloma, or mesh migration into the small and large intestine do occur. Migration of a mesh into the urinary bladder has only been described twice.