Comment on: mesh erosion into the urinary bladder, rare condition but important to know

We read with great interest the article “Mesh erosion into urinary bladder, rare condition but important to know” by Li and Cheng [1]. We completely agree with the authors when they conclude that mesh migration or erosion into urinary bladder, even if rarely reported, is a major complication that can occur after both open and laparoscopic inguinal hernia repair in a wide range of latent period. We recently performed a systematic review of all cases of mesh related visceral complications (MRVCs) reported between 1992 and 2018 in literature, identifying 97 events [2]. It was noted that the number of these complications tripled in the last decade (2007–2017), when compared to the previous one (1992–2002). Sigmoid was the most frequently involved organ, with a total number of 40 cases. Mesh erosion or migration into the urinary bladder was the second (31 cases) mesh related visceral complication, collected by frequency. Recurrent urinary tract infection and hematuria represented the most common reported symptoms. Bladder involvement primarily occurred (83%) after preperitoneal inguinal hernia repair with a slight predominance for the laparoscopic approach (21 cases) compared to the open one (15 cases). Less commonly (13%), it followed 3D techniques, probably when the plug was inserted into the transversalis fascia for the treatment of a direct hernia. In seven patients, bladder lesions were associated with bowel involvement (colovesical fistula). In one case, a bladder calculus resulted from bladder erosion following an undetermined herniorraphy. Ureter involvement following mesh-plug and TAPP repair were other anecdotal MRVCs collected in the review.