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Management of complications of mesh surgery

Lee, Dominic; Zimmern, Philippe E.

doi: 10.1097/MOU.0000000000000187
EVIDENCE BASED UROLOGY: RELATION TO FEMALE UROLOGY: Edited by Christopher R. Chapple

Purpose of review Transvaginal placements of synthetic mid-urethral slings and vaginal meshes have largely superseded traditional tissue repairs in the current era because of presumed efficacy and ease of implant with device ‘kits’. The use of synthetic material has generated novel complications including mesh extrusion, pelvic and vaginal pain and mesh contraction. In this review, our aim is to discuss the management, surgical techniques and outcomes associated with mesh removal.

Recent findings Recent publications have seen an increase in presentation of these mesh-related complications, and reports from multiple tertiary centers have suggested that not all patients benefit from surgical intervention.

Summary Although the true incidence of mesh complications is unknown, recent publications can serve to guide physicians and inform patients of the surgical outcomes from mesh-related complications. In addition, the literature highlights the growing need for a registry to account for a more accurate reporting of these events and to counsel patients on the risk and benefits before proceeding with mesh surgeries.

Department of Urology, University of Texas, Southwestern Medical Center, Dallas, Texas, USA

Correspondence to Philippe E. Zimmern, MD, Department of Urology, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9110, USA. Tel: +1 214 648 9397; e-mail: Philippe.zimmern@utsouthwestern.edu

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