title: Surgical management of mesh-related complications after prior pelvic floor reconstructive surgery with mesh.
abstract: OBJECTIVE
  The objective of this study is to evaluate the complications and anatomical and functional outcomes of the surgical treatment of mesh-related complications.
  
  
  METHODS
  A retrospective cohort study of patients who underwent complete or partial mesh excision to treat complications after prior mesh-augmented pelvic floor reconstructive surgery was conducted.
  
  
  RESULTS
  Seventy-three patients underwent 30 complete and 51 partial mesh excisions. Intraoperative complications occurred in 4 cases, postoperative complications in 13. Symptom relief was achieved in 92% of patients. Recurrence of pelvic organ prolapse (POP) occurred in 29% of complete and 5% of partial excisions of mesh used in POP surgery. De novo stress urinary incontinence (SUI) occurred in 36% of patients who underwent excision of a suburethral sling.
  
  
  CONCLUSIONS
  Mesh excision relieves mesh-related complications effectively, although with a substantial risk of serious complications and recurrence of POP or SUI. More complex excisions should be performed in skilled centers.
authors.affiliation: Department of Obstetrics and Gynaecology 791, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, the Netherlands. myrthetijdink@hotmail.com
authors.forename: Myrthe M
authors.initials: MM
authors.lastname: Tijdink
authors.forename: Mark E
authors.initials: ME
authors.lastname: Vierhout
authors.forename: John P
authors.initials: JP
authors.lastname: Heesakkers
authors.forename: Mariëlla I J
authors.initials: MI
authors.lastname: Withagen
mesh_terms: D020878:Device Removal; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D011475:Prosthesis Failure; D012008:Recurrence; D012189:Retrospective Studies; D013526:Surgical Mesh / Q000009:adverse effects*; D014550:Urinary Incontinence, Stress / Q000209:etiology / Q000601:surgery*