Removal of Mini-Sling Anchor With Magnetic Resonance Imaging–Guided Site Marking With Methylene Blue

TL;DR

A new technique using MRI and methylene blue dye helps surgeons locate and remove hard-to-see mesh anchors causing chronic pelvic pain.

Contribution

The novel use of MRI-guided methylene blue staining to locate and remove radiolucent surgical anchors is introduced.

Findings

MRI-guided methylene blue dye marking successfully localized a radiolucent sling anchor.

The technique provided crucial guidance for transvaginal dissection and anchor removal.

This approach may improve outcomes for patients with persistent chronic pelvic pain after mesh procedures.

Abstract

Pairing magnetic resonance imaging guidance with methylene blue dye marking is a strategy for visualization and removal of radiolucent targets during pelvic surgery.

Single-incision midurethral slings are an alternative to standard midurethral slings for the treatment of stress urinary incontinence. Single-incision midurethral slings use less mesh, relying on soft tissue anchors for mesh stabilization, but can be associated with chronic pain.

We describe the novel use of magnetic resonance imaging to localize and stain a retained radiolucent single-incision midurethral sling anchor with methylene blue dye. This assisted the transvaginal dissection for removal of the stained anchor for a patient with persistent chronic pelvic pain after a prior mesh removal.

Marking the target anchor with dye provided crucial intraoperative guidance for the surgical dissection. This technique can be a valuable tool for localizing surgical targets that are radiolucent.

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