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Totally extra-peritoneal inguinal hernia repair is a minimally invasive procedure that is safe and efficacious as open hernia repair. Despite advancements in technology, the presence of mesh inside the abdomen poses a risk for the development of complications during the post-operative period such as mesh migration, mesh infection, and abscess development. Rarely, this abscess can create a fistula tract between different structures such as the urinary bladder and the skin. An 86-year-old male patient with a 10-year history of laparoscopic bilateral totally extra-peritoneal hernia repair with mesh graft presented with symptoms of watery yellow discharge from the left inguinal region. A mesh-related complication was considered. The patient’s swelling in the inguinal region was diagnosed as an abscess collection and drainage was performed. The computerized tomography of the abdomen revealed a fistula tract formation between the bladder and the skin. The totally extra-peritoneal hernia repair allows the surgical space to be limited to above the peritoneum and avoids entrance inside the abdomen. Although this approach was a breakthrough in the field of hernia surgery, it could lead to a few complications such as seroma development and mesh migration. Patients with complicated mesh infection may result in an abscess development, which can rarely create a fistula tract between different structures such as the urinary bladder and the skin. Any patient presenting with urinary tract infection symptoms with a history of a synthetic mesh should prompt clinicians to consider mesh-related complications in the differential diagnosis.
Cite this article as: Özçelik MF, Orhan O, Erginöz E, Çarkman S. Mesh migration and vesicocutaneous fistula development following totally extra-peritoneal hernia repair. Cerrahpaşa Med J. 2023;47(3):334-336.