Mesh Complications Patient Story 4
Mesh Extrusion and Recurrent Prolapse following Vaginal Mesh for Cystocele
Mesh Complications: Painful intercourse for patient and partner, persistent vaginal bulge and mesh extrusion through vaginal skin.
Treatment: Excision of mesh, Laparoscopic Sacral Colpopexy and Enterocele repair.
The patient is a 58 -yr -old woman from Wyoming who had a vaginal mesh procedure for a cystocele (Avaulta) that was completed three years prior to her visit. This procedure resulted in the mesh extruding through the vaginal wall causing symptoms of pain and "scratching" of her partner's penis with intercourse. She also reported a recurrent bulge vaginally (i.e. recurrent prolapse).
Upon examination, the patient had a large amount of mesh protruding through the skin of the anterior vaginal wall. Additionally, she was found to have vaginal vault prolapse, an apical enterocele, and a high cystocele. The following day after consultation, Drs. Miklos and Moore completed an excision and repair of the exposed vaginal mesh, a Laparoscopic Y-mesh sacral colpopexy and enterocele repair. The abdominal sacral colpopexy is the gold standard repair with the highest cure rates in the literature for vaginal vault prolapse. Drs. Miklos and Moore were able to complete this laparoscopically as an outpatient and achieve an excellent repair. Some mesh extrusions with concomitant prolapse have to be staged (i.e. the mesh extrusion repaired first and allowed to heal) and the prolapse treated at a later date. Drs. Miklos and Moore were able to achieve both procedures safely in one setting, and the patient has recovered without any problems and has excellent vaginal support.
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