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 #2

Posterior Vaginal Wall Mesh – Gynemesh

Surgery:  Rectocele repair with vaginal mesh (Gynemesh)

Symptoms:  Vaginal Pain exacerbated by sexual intercourse

Treatment: Vaginal removal of mesh and revision of posterior repair

Patient is a 40 year old female who had surgery for a rectocele and posterior vaginal vault prolapsed by another physician in Georgia.  The surgeon used Gynemesh the all purpose mesh made by Gynecare for use in reconstructive surgery. The patient claimed to have had pain ever since the surgery and has been suffering for more than a year.  Her pain was exacerbated with intercourse.  Her surgeon told her that all was fine and there was nothing wrong with her.

The patient came to Drs Miklos & Moore at Atlanta Urogynecology Associates  (AUA) practice for evaluation.  Upon examination it was obvious that the pain the patient complained of was easily reproducible.  In other words when she was examined and pressure was applied to the graft the pain was reproduced.   The pain was especially prominent at the proximal edge of the graft.  The proximal edge is the edge closest to the center of the body or deeper into the vagina.  It was readily noted that the edge was readily palpable almost like a tight violin string.  The ridge of the graft was readily palpable and any pressure at all on this edge readily reproduced pain.

It was obvious to the doctors at Atlanta Urogynecology Associates that the mesh needed to be removed because it was the source of pain.   This is a typical case and one of the more common types of cases that the surgeons here at AUA see.  The surgeons at AUA removed the mesh seen here without complication and the patient reported that her pain had resolved.  Dr. Miklos & Moore address patients with these conditions routinely, similar operations to this patient’s procedure include: posterior Prolift, Apogee, Elevate, Avaulta.

PHOTO 1:  Here is a photo of the posterior wall mesh removed from the patient presented above.   The blue stripes are a trademark of Gynecares multipurpose mesh.

Many believe the mesh is the culprit here when in fact the same mesh put in even by the same surgeon or a different surgeon may not have caused pain if it were either put in a little more loosely or if the perhaps the patient didn’t scar so aggressively---it is impossible to tell the difference.  The negligence here is that the original surgeon didn’t address the problem at hand and told the patient there is nothing wrong with her.  If the original surgeon didn’t understand the problem or know what to do with the patient the surgeon should have referred her to a specialist who might know and/or tell the patient that he/she didn’t have an answer for the patient.

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