Mesh Complications Patient Story 21
Vaginal Mesh Extrusion following Anterior Vaginal Wall Mesh Placement for a Cystocele
Mesh Complications: Chronic vaginal pain, dyspareunia (painful intercourse), vaginal mesh extrusion
Treatment: Vaginal approach to remove mesh
This patient is a 40 -year- old female who presents with complaints of mesh extruding through the skin of her vagina for four years. The patient explains in 2004 she was diagnosed with cervical cancer and underwent a radical hysterectomy in Alabama. Afterwards, she had to undergo six months of vaginal radiation therapy.
Drs. Miklos & Moore Comment: Using mesh in patients who have undergone radiation therapy of the vagina may increase the risk of vaginal mesh erosion into the bladder or rectum and extrusion into the vagina. This is not normally recommended by Drs. Miklos & Moore.
In March of 2007 the patient underwent an anterior and posterior Avaulta for a cystocele and rectocele. Only two months later she had mesh extruding through the vagina. In May 2007, she underwent a second surgery to remove the extruding mesh. She returned for her follow-up visit and found the mesh was still extruding through the vagina skin. The doctor placed her on estrogen cream. She saw a new doctor in Pensacola, FL who revised her incision line again to remove the edge of the mesh. The mesh persisted despite his attempts at repair. Six weeks later she came to Atlanta, GA to see Drs. Miklos and Moore for care.
Drs. Miklos and Moore examined her and saw the mesh extruding through the vaginal skin on the anterior vaginal wall. See Figure 1.
Figure 1
Mesh is extruding through the skin of the anterior vaginal wall. The mesh used in this specific case was a soft polypropylene mesh used in a product called Avaulta.
Avaulta Mesh
The patient was taken to the operating room, and the originally placed mesh was completely removed. The patient recovered for 23 hours and went home that week. The removal of the mesh resolved most of her vaginal pain.
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