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

Internationally Renowned Vaginal and Laparoscopic Surgeons

Located in Atlanta, GA – Patients from 47 States and 45 Countries

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Mesh Complication Case Study #12

Vesicovaginal Fistula & Continuous Urine Leakage since Anterior Prolift Surgery for Cystocele

Surgery: Cystocele repair with anterior vaginal wall mesh (Prolift – Gynecare)

Symptoms: Persistent and continuous urine leakage since the surgery for her cystocele repair

Treatment: Laparoscopic and transvaginal approach was required to remove the mesh in the vagina as well as in the bladder.  Upon complete removal of the mesh the vesicovaginal fistula (hole between bladder and vagina) was repaired laparoscopically.

Patient is a 69-year-old woman who was referred to our office by an Atlanta urologist.   The patient had surgery only 5 weeks earlier by a gynecologist who performed a cystocele repair using Anterior Prolift (Gynecare) and by the referring urologist who performed a concurrent TVT sling for urine leakage.

The patient claims:  “The day after surgery, I was in overnight…I started leaking urine and they said it was normal….I left the hospital asking for extra pads”.  Approximately 5 weeks later the urologist diagnosed a fistula and and mesh in the bladder. It was apparent the mesh was due to the Anterior Prolift mesh and not due to the TVT sling.  The urologist sent the patient to Atlanta Urogynecology Associates for evaluation and treatment.

Our examination confirmed a hole as well as mesh in both the vagina and bladder.  This examination and confirmation is consistent with a vesicovaginal fistula (hole between the bladder and the vagina).  The patient was told to wait another 5 weeks before we attempted surgery.  This waiting period allows the tissues to calm down ie get rid of the swelling and inflammation.  The patient was taken to the operating room and the mesh was removed and the VVF repaired laparoscopically.  The patient has been problem free since the surgery.

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