Delayed Intravesical Erosion of Mersilene Tape Used for Cervical Cerclage: A Case Report

Objectives: To describe current literature on long-term sequelae of retained cervical cerclage, focusing on urinary tract complications. To present an illustrative case of a patient with bladder erosion secondary to remote cervical cerclage placement, and discuss her clinical history, diagnostic work-up, surgical management and post-operative course. To outline recommendations for evaluation of chronic refractory bladder pain and highlight surgical approaches to manage intravesical retained foreign bodies.

Methods: We performed a systematic literature review to assess the incidence of late urinary tract complications of cerclage placement, and associations with cerclage surgical technique and suture material. A case report and intraoperative video were compiled describing a 67-year-old female patient with dysuria, urgency, frequency, and intermittent hematuria who was previously diagnosed with interstitial cystitis refractory to standard treatment. Intravesical Mersilene tape, a polyethylene terephthalate suture, was identified on cystoscopy, and suprapubic-assisted transurethral removal with laser excision was performed.

Clinical Relevance: Our literature review identified case reports and case series of bladder calculi, bladder erosions, and vesicocervical, vesicovaginal, and ureterovaginal fistulae formation associated with retained cervical cerclages. Synthetic suture is associated with mucosal erosions and fistulae, and Mersilene tape for cervical cerclage has been shown to increase risk of urinary tract erosion and infection.



A thorough obstetric and gynecologic history is needed for all female urologic patients with lower urinary tract symptoms and chronic bladder pain. The knowledge of this patient’s prior cervical cerclage was critical for diagnosis and determination of surgical approach. The case underscores the importance of cystoscopy as part of the diagnostic evaluation of patients with hematuria, recurrent urinary tract infections, and persistent lower urinary tract symptoms after initial treatment. Early suspicion for and recognition of retained foreign body may have spared our patient from unnecessary procedures and antibiotic exposure, and could have implications for reducing antibiotic resistance and cost savings at the systems-level.