Dr. John Miklos and Dr. Robert Moore – Vaginal Mesh Complication Surgeons

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Mesh Complication Case Study #10

Sacral Colpopexy Mesh Extrusion (Y-Mesh Graft)

Surgery: Vaginal approach to sacral colpopexy mesh removal

Symptoms: Bloody vaginal discharge, Extruding vaginal mesh, Pain with intercourse

Treatment: Vaginal removal of approximately 1/2 of the Teflon coated polypropylene mesh from the apex of the vagina.

Patient is a 68-year-old female who has a history of multiple reconstructive vaginal surgeries.  She had the following surgical procedures over the last 9 years:

• 2002 – TAH (Hysterectomy), Burch urethropexy,
• 2003 – Laparoscopic sacral colpopexy (by Dr Miklos)
• 2006 – Posterior Repair w/ AMS Mesh (Apogee) – by Dr Miklos
  
  
• 2010 – Removal of Gortex Sacral Colpopexy Mesh (performed in 1988) The patient presented with the above symptoms and exam revealed complete extrusion of the mesh through a perforation at the apex of the vagina.
  
  The mesh was removed through the vaginal opening.  The mesh was cut away and the edges of the area of skin perforation were trimmed to make them free of scar and the defect was closed using suture.  The patient was discharged the day after surgery and was without pain.
  

Please note that the patient’s support of the rectum Ie posterior repair with American Medical Systems (AMS) mesh is doing well 8 years after her mesh was placed on the posterior vaginal wall.  This procedure continues to work for the rectocele and the mesh in this area has created any problems.  The mesh used for the sacral colpopexy (2003) was Teflon coated polypropylene mesh, which is no longer, made by the company that once produced it.  The company pulled the mesh off the market because this mesh often became infected.

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