OBJECTIVE: Complications from transvaginal mesh placed for prolapse often require operative management. The aim of this study is to describe the outcomes of vaginal mesh removal.
METHODS: A retrospective review of all patients having surgery by the urogynecology group in the department of obstetrics and gynecology at our institution for a complication of transvaginal mesh placed for prolapse was performed. Demographics, presenting symptoms, surgical procedures, and postoperative symptoms were abstracted. Comparative statistics were performed using the χ2 or Fisher’s exact test with significance at P<.05.
RESULTS: Between January 2008 and April 2012, 90 patients had surgery for complications related to vaginal mesh and 84 had follow-up data. The most common presenting signs and symptoms were: mesh exposure, 62% (n=56); pain, 64% (n=58); and dyspareunia, 48% (n=43). During operative management, mesh erosion was encountered unexpectedly in a second area of the vagina in 5% (n=4), in the bladder in 1% (n=1), and in the bowel in 2% (n=2). After vaginal mesh removal, 51% (n=43) had resolution of all presenting symptoms. Mesh exposure was treated successfully in 95% of patients, whereas pain was only successfully treated in 51% of patients.
CONCLUSION: Removal of vaginal mesh is helpful in relieving symptoms of presentation. Patients can be reassured that exposed mesh can almost always be successfully managed surgically, but pain and dyspareunia are only resolved completely in half of patients.
LEVEL OF EVIDENCE: III
The presenting symptoms of a complication from transvaginal mesh placed for prolapse resolve in half of women who opt for surgical removal of the mesh.
Departments of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, and Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Corresponding author: Erin C. Crosby, MD, L4000 Women's Hospital, 1500 E Medical Center Drive, Ann Arbor, MI 48109; e-mail: firstname.lastname@example.org.
Financial Disclosure Dr. Delancey is a consultant for American Medical Systems. The other authors did not report any potential conflicts of interest.