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Autologous Graft for Treatment of Midurethral Sling Exposure Without Mesh Excision

Jeppson, Peter C. MD; Sung, Vivian W. MD, MPH

doi: http://10.1097/AOG.0b013e31826d27e3
Case Report
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BACKGROUND: The midurethral sling is an effective treatment for stress urinary incontinence. Mesh exposure is a known complication of this procedure, with an associated rate of approximately 4%. Other than sling excision, there is minimal information on other options that may help to preserve an effective sling when an exposure has occurred.

CASE: A patient presented with a mesh exposure 9 weeks after a retropubic midurethral sling. Conservative treatment with vaginal estrogen failed, as did primary reclosure in the operating room. She was then successfully treated with a full-thickness autologous vaginal epithelium graft.

CONCLUSION: We report an alternative surgical option to mesh excision, which may help preserve an otherwise effective midurethral sling complicated by mesh exposure.

An alternative surgical option to mesh excision may help preserve an otherwise effective midurethral sling complicated by mesh exposure.

Department of Obstetrics and Gynecology, Division of Urogynecology and Reconstructive Pelvic Surgery, Alpert Medical School of Brown University, Providence, Rhode Island.

Corresponding author: Peter C. Jeppson, MD, 695 Eddy Street, Providence, RI 02903; e-mail: peterjeppson@gmail.com.

Dr. Sung is supported by grant K23HD060665 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and by an American Urogynecologic Society Foundation Grant.

Presented at the Society of Gynecologic Surgeons 2012 Annual Scientific Meeting, April 13–15, 2012, Baltimore, Maryland.

The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the Eunice Kennedy Shriver National Institute of Child Health and Human Development or the National Institutes of Health.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2013 The American College of Obstetricians and Gynecologists