Early experience with mesh excision for adverse outcomes after transvaginal mesh placement using prolapse kits.
OBJECTIVE
The purpose of this study was to determine the complications, treatments, and outcomes in patients choosing to undergo removal of mesh previously placed with a mesh procedural kit.


METHODS
This was a retrospective review of all patients who underwent surgical removal of transvaginal mesh for mesh-related complications during a 3-year period at Cleveland Clinic. At last follow-up, patients reported degree of pain, level of improvement, sexual activity, and continued symptoms.


RESULTS
Nineteen patients underwent removal of mesh during the study period. Indications for removal included chronic pain (6/19), dyspareunia (6/19), recurrent pelvic organ prolapse (8/19), mesh erosion (12/19), and vesicovaginal fistula (3/19), with most patients (16/19) citing more than 1 reason. There were few complications related to the mesh removal. Most patients reported significant relief of symptoms.


CONCLUSIONS
Mesh removal can be technically difficult but appears to be safe with few complications and high relief of symptoms, although some symptoms can persist.
Ridgeway
Beri
B
Obstetrics, Gynecology, and Women's Health Institute, Cleveland Clinic, Cleveland, OH, USA.
Walters
Mark D
MD
Paraiso
Marie Fidela R
MF
Barber
Matthew D
MD
McAchran
Sarah E
SE
Goldman
Howard B
HB
Jelovsek
J Eric
JE
D000328:Adult; D000368:Aged; D020878:Device Removal; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D017699:Pelvic Pain / Q000503:physiopathology; D011183:Postoperative Complications / Q000601:surgery; D012008:Recurrence; D012086:Reoperation; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013526:Surgical Mesh / Q000009:adverse effects*; D013997:Time Factors; D014596:Uterine Prolapse / Q000175:diagnosis / Q000601:surgery*