Vaginal Mesh Kits Complications: Vagina mesh extrusion / visible mesh

This is the most common complication reported and typically considered a minor complication and one that is taken care of relatively easily with a minor surgical procedure. Vaginal mesh extrusion with mesh kits has been shown in studies to be in the range of 5 to 15%. This number has been dramatically reduced in recent years with the advent of newer, lighter, softer Type I mesh. The original studies reporting on kits such as Perigee/Apogee as well as Prolift used a much heavier mesh than is currently being used and therefore the extrusion rates were higher (in the rates of 10-15%). Mesh technology has improved and recent studies using lighter mesh has shown the extrusion rate has dropped more than 50% some cases. This also has to do with improved surgical technique and surgeon experience as well.  Dissection techniques of placing the mesh deeper have also led to lower extrusion rates. Drs. Moore and Miklos recently published a study with this lighter mesh and had extrusion rates <1% (Anterior elevate AAGL abstract).

When a mesh extrusion occurs, it typically will cause vaginal discharge, bleeding or pain. In many cases the surgeon may notice this prior to the patient experiencing any symptoms as there may have been an issue in healing that caused the exposure. Extrusions that happen early may heal over with conservative therapy such as antibiotics and/or estrogen cream. If it does not heal or is a large exposure, a minor procedure involving excising or trimming the exposed mesh and repair of the defect is necessary.

Click images below to enlarge.

Normal Mesh

Mesh Extrusion in Vagina from Bladder

Mesh Extrusion in Vagina from Rectum