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

Call now for a Confidential Consultation with Carrie (770) 475-0862

• Home
• Mesh Complications
  • Overview
  • Incontinence Surgery (TVT, TOT, Mini-Slings)
  • TVT Sling Complications
  • TOT Sling Complications
  • Mini-sling Complications
  • Prolapse Surgery (Vaginal Mesh Complications)
  • Vaginal Mesh Kit Complications (Prolift, Apogee/Perigee, Avaulta, Elevate)
  • Sacralcolpopexy Mesh Complications
• Treatments
  • Overview
  • Mesh Extrusion
  • Mesh Erosion into viscera (bowel, bladder)
  • Pain - Vaginal, Pelvic, Leg, Buttock, and/or Abdominal
  • Urinary Symptoms
  • Recurrent UTI's
  • Failure/Recurrent Prolapse
  • Bowel symptoms
  • Shortened Vagina
• Procedures
  • Mesh Kits for Prolapse
    • Prolift (Anterior/Posterior), Prosima, Gynemesh *Gynecare
    • Avaulta Solo (Ant/Post), Avault Plus (Biosynthetic), Pelvitex Mesh *Bard Urology
    • Pinnacle (Anterior/Vault), Uphold (Vault), Polyform Mesh *Boston Scientific
    • Restorelle (Ant/Post), Restorelle (EzA) *Coloplast/Mpathy
    • Apogee (Post), Perigee (Anterior), Elevate Anterior, Elevate Posterior *American Medical Systems (AMS)
    • Posterior IVS *US Surgical
    • Ascend Anterior, Ascend Posterior *Caleda Medical
  • Slings
    • TVT *Gynecare
    • Sparc *AMS
    • Align *Bard Urology
    • Lynx, Advantage *Boston Scientific
    • IVS Tunneller *US Surgical
    • T Sling, Desara *Caldera Medical
    • TVT-O, TVT Abbrevo *Gynecare
    • Monarc *AMS
    • Align-TO, Uretex-TO *Bard Urology
    • Obtryx *Boston Scientific
    • Obtape *Mentor
    • T Sling, Desara-TO *Caldera Medical
    • Secur *Gynecare
    • MiniArc *AMS
    • Solyx *Boston Scientific
• Case Studies
  • TVT-type Sling Complications
    • TVT Sling – Urinary Retention, Lower Abdominal Pain
    • Sparc (TVT-type) Sling – Pain at the urethra
    • TVT Sling - Vaginal Extrusion
    • TVT (Lynx) - Leg, Vaginal Pain-Laparoscopic removal
    • Mesh in Bladder – Pain and Vaginal Bleeding
    • TVT Sling/Perigee Complication – Vaginal Bulge
    • TVT sling - Recurrent prolapse, persistent urinary leakage, mesh extrusion
    • TVT (Align) Sling and Posterior Avaulta Complication
    • TVT Sling Complication: Mesh Extruding Through Vaginal Epithelium
    • Vaginal Pain, Bloody Urine, Difficulty Walking Because of Lower Abdominal Pain
    • TVT Sling (Gynecare) – Pelvic Pain, Vaginal Pain, Painful Intercourse
  • TOT Sling Complications
    • Urinary Retention Following TVT-O Sling and Recurrent Prolapse
    • Leg and Groin Pain following TOT Sling
    • Leg Pain and Urinary Leakage
    • Vaginal Pain, Pain with sex
    • Pain and Urinary Leakage S/P Perigee and TOT Sling
    • Avaulta/TOT Sling Complication – Severe vaginal and buttock pain, pain w/ intercourse
    • TOT sling / Obtryx / Boston Scientific - Vaginal Pain
  • Mini Sling Complications
    • Complication of Mini Sling (Solyx-Boston Scientific, MiniArc Sling – AMS, Secure –Gynecare)
    • Complication of a Mini Sling (Ajust- Bard Urology)
  • Mesh Extrusion and Recurrent Prolapse
  • Posterior Wall Mesh Complications
    • Posterior Vaginal Wall Mesh – GyneMesh - Vaginal pain with intercourse
    • Posterior Vaginal Wall Mesh – Chronic Abscess/infection, Drainage from Buttock Cheek Tract
  • Prolift, Apo/Perigee Complications
    • Pain and Urinary Leakage S/P Perigee and TOT Sling
    • Vesicovaginal Fistula & Continuous Urine Leakage since Anterior Prolift Surgery for Cystocele
    • Chronic Abscess/Infection, Drainage from Buttock Cheek tract
    • Vaginal/Buttock Pain, Mesh exposure, Pain w/ Intercourse
  • Avaulta Complications
    • Pain with intercourse since Posterior Avaulta for Rectocele
    • Persistent Chronic Vaginal Pain since Posterior Avaulta for Rectocele
    • Vaginal and Buttock Pain Following Total Vaginal Mesh
    • Anterior Avaulta-Mesh Extrusion, Vaginal Pain
    • Avaulta/TOT Sling Complication – Severe vaginal and buttock pain, pain w/ intercourse
    • Chronic vaginal pain, vaginal mesh extrusion
  • UpHold Complications
    • UpHold Mesh Complication - Pain and Mesh Extrusion
    • UpHold Complication – mesh exposure, pain with intercourse (husband can feel mesh)
  • Sacral Colpopexy Mesh Complications
    • Sacral Colpopexy Mesh Extrusion (Gortex Mesh Graft)
    • Sacral Colpopexy Mesh Extrusion (Y-Mesh Graft)
    • Abcess post LAVH/Sacralcolpopexy
    • Sacral Colpopexy Mesh Abscess and Mesh Extrusion
    • Sacral Colpopexy Mesh Pain (Gynemesh Graft Removal)
• Scientific Papers
• Testimonials
• Blog
• Discussion Board
• Our Websites

Mesh Complication Case Study #15

TVT Sling Complication - Vaginal, Urethral, Left-sided inguinal, Thigh and Labia Pain

Surgery:  TVT sling  (Lynx – Boston Scientific)

Symptoms:  Vaginal pain, urethral pain, Left sided inguinal, thigh and labia pain

Surgery:  Vaginal & Laparoscopic approach to complete removal of TVT sling

Patient is a 39 year old female who presented to Dr Miklos and Moore with left sided inguinal, left labia and left sided inner thigh pain x 5 weeks.  She had undergone surgery only 5 weeks prior in  Colorado where she underwent surgery by a Urogynecologist. 

Her original surgery included:

TVH (total vaginal hysterectomy)
Uterosacral vault suspension
TVT sling

Her symptoms 5 weeks after surgery:

• Left inguinal pain
• Left labia pain
• Left inner thigh pain
• Anterior vaginal wall pain

The original surgeon’s operative report revealed the bladder was punctured using the TVT needle at the time of delivery of the TVT sling on the patients left side.  (Comment:  this is not an unusual intra- operative complication and rarely causes any problems post operatively – John R Miklos, MD). The surgeon then states she moved the needle further lateral to the initial site of the TVT needle puncture (ie further left) to avoid puncturing the bladder again. 

Dr. Miklos and Moore explained to the patient it is common to be able to remove the sling without much trauma at 4 – 6 weeks after surgery.  This surgery can usually be performed by making a small incision in the vagina underneath the area of the recently placed TVT, dissecting the sling away from the urethra, grasping the sling and just pulling it out.  However after this time the scar tissue is so significant the surgeon must now approach through incisions in the abdomen and the sling must be dissected away from all of the newly formed scar tissue which is now securing the sling in place behind the pubic bone and up into the abdominal wall.   

Dr. Miklos & Moore attempted removal from below and found the sling was so severely scarred in place they needed to convert to a laparoscopic approach (mini incisions) and removed the sling from above.  (FIGURE 1)  The surgery took approximately 2 hours and 30 minutes the patient spent the night in the hospital and subsequently discharged the next day.  She returned to Colorado 72 hours after surgery.  On the first day after surgery the patient already felt an improvement in the tension and pressure inside of her vagina.  She continues to do well following the surgery.

Mesh Surgeons Home