Complications from vaginally placed mesh in pelvic reconstructive surgery.
OBJECTIVE
We describe complications associated with the use of transvaginal mesh for treatment of pelvic organ prolapse.


METHODS
We retrospectively identified patients referred to our institution from January 2003 through September 2007 who had complications after vaginal placement of mesh.


RESULTS
We identified 21 patients with a mean (SD) age of 61 (11) years. Types of mesh used included mesh kits (n = 9, 43%), nontrocar mesh augmentation (n = 5, 24%), IVS Tunneller (n = 4, 19%), and unspecified (n = 3, 14%). Eleven patients (52%) underwent more than one procedure before referral. Only three patients were referred by the original treating surgeon. Complications included mesh erosions in 12 women, dyspareunia in ten, and recurrent prolapse in nine. Sixteen patients (76%) were managed surgically. Follow-up survey among sexually active patients showed 50% with persistent dyspareunia.


CONCLUSIONS
Use of vaginal mesh for pelvic reconstruction can produce complications. Multiple interventions may be necessary, and bothersome symptoms may persist.
Blandon
Roberta E
RE
Department of Obstetrics and Gynecology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Gebhart
John B
JB
Trabuco
Emanuel C
EC
Klingele
Christopher J
CJ
D000368:Aged; D016063:Blood Loss, Surgical; D001810:Blood Volume; D004414:Dyspareunia / Q000209:etiology*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D061646:Operative Time; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D017699:Pelvic Pain / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D011475:Prosthesis Failure / Q000209:etiology*; D011788:Quality of Life; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D013526:Surgical Mesh / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000209:etiology; D014621:Vagina / Q000473:pathology; D019522:Vaginal Discharge / Q000209:etiology