title: Surgical treatment of persistent vaginal granulation tissue using CO(2) laser vaporization under colposcopic and laparoscopic guidance.
abstract: BACKGROUND
  There have been many reports in the literature on vaginal mesh erosion as a complication of pelvic floor reconstructive surgery. Several reports describe successful surgical excision of the exposed mesh as a resolution. However, in rare cases of mesh erosion, poor  surgical outcomes and multiple resection failures have been reported. We describe an innovative surgical approach to persistent vaginal mesh erosion using CO(2) laser vaporization under colposcopic and laparoscopic guidance.
  
  
  METHODS
  A 58-y-old postmenopausal woman  first presented with a 3-y history of vaginal discharge and spotting after undergoing a Mentor ObTape transobturator sling (Mentor Corp, Santa Barbara, CA), for the treatment of stress urinary incontinence. Despite surgical removal of the mesh and multiple attempts at cauterization of persistent  granulation tissue, her symptoms persisted.
  
  
  CONCLUSIONS
  Using a CO(2) laser under colposcopic and laparoscopic guidance, we were able to safely expose and remove the remaining portion of retained mesh. To our knowledge, this is the first report describing CO(2)  laser vaporization as a surgical approach for the successful treatment of recurrent mesh erosion.
authors: Cooper University Hospitals, Division of Female Pelvic Medicine and Reconstructive Surgery, Camden, NJ, USA. steinberg-benjamin@cooperhealth.edu
authors: Benjamin J
authors: BJ
authors: Steinberg
authors: Tiffany
authors: T
authors: Mapp
authors: Saifuddin
authors: S
authors: Mama
authors: Karolynn T
authors: KT
authors: Echols
mesh_terms: D005260:Female; D006097:Granulation Tissue / Q000473:pathology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D053685:Laser Therapy / Q000379:methods*; D054020:Lasers, Gas / Q000627:therapeutic use*; D008875:Middle Aged; D011475:Prosthesis Failure; D053825:Suburethral Slings / Q000009:adverse effects*; D014550:Urinary Incontinence, Stress / Q000601:surgery; D019522:Vaginal Discharge / Q000209:etiology / Q000473:pathology / Q000601:surgery*