Mesh complications following prolapse surgery: management and outcome

Abstract

Objective: This is a description of complications following prolapse surgery with the use of alloplastic materials, the management and outcome.

Study design: 54 women have been referred to Mainz, urogynecology referral center due to complications following mesh-augmented prolapse surgery.

Results: The complaints who lead to the admission are expressed by the new terminology and standardized classification for complications arising directly from the insertion of prostheses and grafts in female pelvic floor surgery [1]. Pain (66.7%), mesh erosion (55.6%) and vaginal discharge (48.1%) were the most frequent complaints. Revision was performed after a median time of 27.2 months post mesh implantation. Nine patients underwent limited excision of the mesh, 49 had a vaginal revision with wide mesh removal and 10 had a laparotomy with wide mesh removal. After 3 months 48 patients had a follow-up, 25 could have been relieved from their complaints.

Conclusion: Although the incidence is low, complications after prolapse repair with mesh use are difficult to prevent, affect quality of life and often require a new surgical intervention, which should be performed by an experienced and competent surgeon.