Mesh-related chronic infections in silicone-coated polyester suburethral slings.
OBJECTIVE
despite claims of equivalence to the tension-free vaginal tape, a variety of suburethral slings have been introduced, with various modifications. Complications in certain synthetic slings and meshes have led to a recent FDA public health notification.


METHODS
we report the case histories and management of five women with complications following implant of an InFast sling.


RESULTS
four of the five patients presented with symptom of chronic vaginal discharge, one presenting with irritative voiding symptoms and bladder pain. Resolution of presenting symptoms requires total removal of this silicone-coated polyester mesh, which often requires a combined vaginal-abdominal approach.


CONCLUSIONS
the silicone-coated mesh of the AMS InFAST sling, can become a focus for chronic infection forming a sinus tract into the vagina or other viscus, causing symptoms years after its placement.
Lee
Joseph K-S
JK
Department of Urogynaecology, Mercy Hospital for Women, 169 Studley Road, Heidelberg, Melbourne, 3084 VIC, Australia. jlee@mercy.com.au
Agnew
Gerard
G
Dwyer
Peter L
PL
D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000453:epidemiology / Q000209:etiology; D020878:Device Removal; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000295:instrumentation / Q000379:methods; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology / Q000209:etiology; D011091:Polyesters; D012828:Silicones; D053825:Suburethral Slings / Q000009:adverse effects*; D013526:Surgical Mesh / Q000009:adverse effects*; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D019522:Vaginal Discharge / Q000453:epidemiology / Q000209:etiology; D014623:Vaginal Diseases / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology*
D011091:Polyesters; D012828:Silicones