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Surgically Treated over 400 Mesh Complications in 2012
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Mesh Complications Patient Story 16

Chronic Abscess, Infection & Pus Drainage from Buttock Cheek after Posterior Vaginal Mesh Surgery

Mesh Complications: Persistent sinus tract from right buttock cheek, gluteal pain and multiple abscesses for two-three years

Treatment: Complete removal of posterior vaginal wall mesh and associated mesh arm from gluteus (buttocks) muscle

The patient is a 63- year- old female who flew to Atlanta, GA from Baltimore, MD to see Drs. Miklos and Moore for treatment of what she had been told was a rectovaginal fistula that had persisted for almost three years.

The patient had an Apogee (AMS) posterior vaginal wall mesh procedure in 2007. (Figure 1) She was doing well until 2009. She then began having drainage from her sinus tract, which started out as a pimple/bump on her right buttock. She initially consulted a general surgeon who believed it was a simple abscess. This surgeon performed surgery to the affected area without success.


Patient Story 16
Figure 1: Apogee Mesh

The patient consulted a colorectal surgeon at the Johns Hopkins University Hospital. In his opinion the first surgeon did not perform an aggressive enough procedure. This particular surgeon operated on the patient three more times. During the last surgery he placed what is known as a Seton. When this operation failed he referred the patient to another colorectal surgeon. The new colorectal surgeon realized there was mesh in the sinus tract and diagnosed her with a fistula.

“I have seen (NINE Different) surgeons over the past two years and you are my last chance!” Patient’s statement to Dr. Miklos

The patient then went through the painful task of visiting FIVE more doctors. Upon recommendation she sought out Dr. Miklos & Moore in Atlanta, Ga based on their extensive experience in vaginal mesh complications. On examination it was evident she had a sinus tract, which was draining pus and bloody fluid from her right buttock cheek. This is a very unusual complication from the Apogee procedure. This particular mesh has been shown to have low rates of complications, however, with any surgery complications can occur and appropriate treatment by an experienced surgeon is needed.

Patient Story 16
Figure 2: Sinus tract in patients right buttocks cheek

After an informed consent the patient elected to go to surgery and the mesh was removed. Drs. Miklos & Moore started the surgery at the opening of the vagina and needed to dissect the mesh from the overlying skin and away from the underlying rectum. At this point further dissection was done into the vaginal wall attempting to dislodge the mesh and clean up any further abscessed areas. After completing the dissection via the vagina the surgeons then turned their attention to the buttock area and began by dissection through the buttock (gluteus muscle) until the mesh was adequately dislodge and the mesh was removed.

Patient Story 16
Figure 3: Removed Apogee mesh

For clarification, where the mesh was dissected Drs. Miklos & Moore placed a clean new piece of synthetic mesh through the hole in the buttock cheek and out through the hole in the vagina wall. This was done strictly for teaching purposes for others to understand the pathway of the original mesh and where the sinus tract developed.

Figure 4: Identifying the pathway of where the Apogee mesh was and where the sinus tract & abscesses developed

Click here to find out more about Posterior Wall Mesh complications.

Click here to find out more about Vaginal Mesh Kit complications.

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