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

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

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Mesh Complication Case Study #33

TOT Sling - Obtryx - Boston Scientific Complication

Initial Mesh Surgery: TOT sling – Obtryx – Boston Scientific

Post Mesh Surgery Symptoms: Vaginal pain and painful intercourse

Treatment to Repair Mesh Complications: A transvaginal approach to remove the mesh from underneath and beside the urethra out to/but not including the removal of the sling where it penetrates the obturator internus muscles

Patient is a 56 year old female with a chief complaint of “bad pain” on the right side of the vagina for almost 2 years.  The patient claims the pain started after her TOT sling procedure was performed in Florida in 2009 for stress urine incontinence.  According to the operative report she had a Boston Scientific pubovaginal sling known as an Obtryx. (Figure 1) Post operatively she has been without leakage however she now suffers with pain.  Six months after the operation in September 2009 she went to a different surgeon because the initial surgeon who placed the sling told the patient there was nothing wrong with her.  She then a saw a new surgeon, a urologist in Bradenton, FL.  The urologist attempted to revise the sling.    The surgery performed had not relieved the vaginal pain so she came to Atlanta, Georgia for her sling removal.

Dr. Miklos saw the patient in August 2011.  Physical examination revealed reproducible pain on each side of the urethra (the normal position of the sling after placement).   The patient elected to go to surgery the next day the sling was identified by palpation through the skin; the skin incised in the midline under the urethra, the sling was visually identified and then divided in the midline. The sling was dissected laterally to the point of insertion into the obturator internus muscles bilaterally.  The sling was removed and the patient was discharged from the hospital the same day.  (Figure 2)

Figure 1 - The Obtryx Sling

Figure 2 - The portion of the sling removed from the patient.
It was cutinto two pieces which made removal easier.

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