Urethral diverticulum complicated by multiple calculi secondary to urethral mesh erosion: A case report

The case of a 65-year-old woman with a complication 15 years after mesh repair of vaginal prolapse is presented. The patient presented with chronic pelvic pain, recurrent urinary tract infections (UTIs), foul-smelling vaginal discharge, and urinary frequency/urgency for the previous eight years. Magnetic resonance imaging led to the diagnosis of vaginal mesh erosion and a urethral diverticular calculus secondary to urethral mesh erosion. Transvaginal removal of the mesh erosion was performed with simultaneous exploration of the urethral diverticulum, removal of a urethral stone, and urethral reconstruction using a multi-layer approach. Three months later she was symptom-free and continent. This case adds to the limited literature on urethral diverticulum with calculi secondary to mesh erosion, and highlights the need for long-term follow-up and clinician awareness of this rare, delayed complication.