Use of Surgisis mesh in the management of polypropylene mesh erosion into the vagina

Abstract

Introduction and hypothesis: mesh in pelvic reconstructive surgery is being used increasingly in clinical practice. Complications such as mesh erosion and dyspareunia can cause significant patient morbidity. In cases where vaginal mesh erosions are large or multifocal resulting in inadequate healthy epithelium for repair, this may lead to recurrent mesh erosion or vaginal stenosis.

Method: nine patients with synthetic mesh erosion who failed to respond to conservative measures were managed surgically with Surgisis.

Results: the median time at which patients presented with mesh erosion was 12 weeks. The size of erosion ranged from 1 to 4 cm in diameter. At follow-up, five patients were cured, three still had evidence of mesh erosion although the overall defects were smaller, and one patient required further surgery.

Conclusion: with mesh erosion being a troublesome reality following insertion of synthetic mesh repairs, Surgisis may prove to be a useful option in the treatment of large vaginal mesh defects.