Complications requiring reoperation following vaginal mesh kit procedures for prolapse.
OBJECTIVE
The objective of the study was to the characterize the symptoms and management of vaginal mesh-related complications requiring operative intervention.


METHODS
This was a case series of patients undergoing excision of vaginal graft material. Only women who had vaginal mesh placement for the correction of pelvic organ prolapse (POP) were included. We describe the symptoms, complications, and management of women treated surgically for vaginal mesh-related complications.


RESULTS
Thirteen referred women underwent surgery for vaginal mesh-related complications. All meshes were Apogee and/or Perigee. Ten had symptomatic mesh exposures, 1 had an exposure with pelvic abscess, and 2 had pain syndromes without mesh exposure. Patients also had rectovaginal fistula, vesicovaginal fistula, recurrent POP, and persistent discharge. Five women had prior surgery for this problem. All patients underwent transvaginal mesh excision and other indicated procedures at our institution, and 6 women required a second surgery at our institution, with a median of 2 surgeries per patient.


CONCLUSIONS
Vaginal mesh placement for POP can be associated with pain, exposure, and fistula formation, requiring multiple operative interventions.
Margulies
Rebecca U
RU
Pelvic Floor Research Group and the Department of Obstetrics and Gynecology, University of Michigan School of Medicine, Ann Arbor, MI, USA.
Lewicky-Gaupp
Christina
C
Fenner
Dee E
DE
McGuire
Edward J
EJ
Clemens
J Quentin
JQ
Delancey
John O L
JO
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D020878:Device Removal; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008875:Middle Aged; D011475:Prosthesis Failure; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D053825:Suburethral Slings / Q000009:adverse effects*; D013526:Surgical Mesh / Q000009:adverse effects*; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000175:diagnosis / Q000601:surgery*