Mesh Complications Patient Story 38
Mesh Extrusion & Vaginal Bleeding following TVT-O Sling
Mesh Complications: Vaginal spotting and bleeding since for three years
Treatment: Sling revision and removal
The patient is a 69-year-old woman who had surgery three years ago for urine leakage and vaginal prolapse. Her surgeon performed a TVT-O sling as well as an anterior vaginal wall and posterior vaginal wall prolapse with mesh (Prolift). The patient claims she did fine, but on occasion she would have spotting from her vagina. She denied pain and was not sexually active.
Three years after the surgery the patient saw a sudden gush of blood from her vagina. She consulted her treating surgeon who recommended removal of the sling. She decided to come to Drs. Miklos & Moore in Atlanta, GA because of their experience and expertise in the field of mesh complications and vaginal surgery. Examination of the patient revealed complete exposure of the mesh under the urethra. (Figure 1)
The patient was taken to surgery, and a retractor was placed to allow better visualization of the mesh, which extruded through the vaginal skin. (Figure 2) A surgical instrument was used to dissect the mesh from the urethra and the vaginal skin. (Figure 3 & 4) The sling was dissected laterally to its point of attachment to the vaginal sidewall. The sling was divided and removed from the patient and then the vaginal skin was closed. The patient did well post-operatively and has had no further vaginal bleeding. A photo of the sling is pictured. (Figure 5)
Figure 1: The exposed TVT-0 sling as seen in the office
Figures 3 & 4: The sling further exposed by using a surgical instrument to free the sling from the underlying scar and urethra
Figure 4
Figure 5: The removed sling measuring approx. 6 cm. (equivalent to 2-3 inches in length)
