October 18th, 2018

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Bladder Erosion Related to Shirodkar Cerclage Placement: A Case Report
Authors:  John S. Joyce, M.D., Christopher P. Chung, M.D., and Paul M. Yandell, M.D.
BACKGROUND: Erosion into the bladder following cerclage placement is a rare complication, with few reported cases to guide management. Unfortunately, there is a paucity of data describing the optimal approach to removing foreign bodies from the bladder. Shirodkar cerclage placement requires dissecting the bladder and posterior cul-de-sac peritoneum off the cervix prior to placing either permanent sutures or a 5-mm Mersilene tape. The cerclage may be left in place if the patient desires a cesare-an section and plans future pregnancy. However, strong consideration should be given to removal when childbearing is no longer desired.

CASE: We present a patient with surgical tape erosion into the bladder 28 years after Shirodkar cerclage placement and then describe our minimally invasive approach for removing this tape.

CONCLUSION: Shirodkar cerclage is susceptible to delayed erosion into the bladder. Suprapubic-assisted cystoscopic removal of foreign material may be feasible using the Carter-Thomason CloseSure system.
Keywords:  abdomen; cerclage of uterine cervix; cervical cerclage; cystoscopy; foreign-body reaction; gynecologic surgical procedures; shirodkar cerclage, urinary bladder
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