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Vaginal Apical Pain After Sacrocolpopexy in Absence of Vaginal Mesh Erosion

A Case Series

Buechel, Megan MD; Tarr, Megan E. MD; Walters, Mark D. MD

Female Pelvic Medicine & Reconstructive Surgery: January/February 2016 - Volume 22 - Issue 1 - p e8–e10
doi: 10.1097/SPV.0000000000000218
Case Reports
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Introduction Sacrocolpopexy is one of the most effective surgeries to correct pelvic organ prolapse. Previous studies have described complications, such as mesh erosion and dyspareunia. However, there are few studies on the development of pelvic pain in the absence of mesh erosion in patients who have undergone sacrocolpopexy.

Case Reports We describe 3 patients who presented with apical vaginal pain in the absence of mesh erosion remote from sacrocolpopexy. All patients were refractory to conservative therapies and underwent abdominal excision of mesh with improvement of symptoms postoperatively.

Conclusions The development of de novo pain in the absence of mesh erosion after sacrocolpopexy is an uncommon event but in our cases required complete excision for relief of symptoms. Further research will be needed to understand if surgical technique or materials may be related to the development of symptoms.

We present a series of patients presenting with de novo pain in the absence of vaginal mesh erosion after sacrocolpopexy and discuss their management as well as surgical techniques that may play a role in the development of this complication.

From the Cleveland Clinic, Obstetrics, Gynecology & Women’s Health Institute, Cleveland, OH.

Reprints: Megan Buechel, MD, Cleveland Clinic, Obstetrics, Gynecology & Women's Health Institute, 9500 Euclid Avenue A81, Cleveland, OH 44195. E-mail: Buechem@ccf.org.

Conflicts of Interest and Source Funding: Dr. Mark Walters has worked as a consultant for Ethicon and has received a royalty for work performed with Elsevier. Dr. Megan Buechel and Dr. Megan Tarr have no conflicts of interest to disclose.

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.