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

Call now for a Confidential Consultation with Carrie (770) 475-0862

• Home
• Mesh Complications
  • Overview
  • Incontinence Surgery (TVT, TOT, Mini-Slings)
  • TVT Sling Complications
  • TOT Sling Complications
  • Mini-sling Complications
  • Prolapse Surgery (Vaginal Mesh Complications)
  • Vaginal Mesh Kit Complications (Prolift, Apogee/Perigee, Avaulta, Elevate)
  • Sacralcolpopexy Mesh Complications
• Treatments
  • Overview
  • Mesh Extrusion
  • Mesh Erosion into viscera (bowel, bladder)
  • Pain - Vaginal, Pelvic, Leg, Buttock, and/or Abdominal
  • Urinary Symptoms
  • Recurrent UTI's
  • Failure/Recurrent Prolapse
  • Bowel symptoms
  • Shortened Vagina
• Procedures
  • Mesh Kits for Prolapse
    • Prolift (Anterior/Posterior), Prosima, Gynemesh *Gynecare
    • Avaulta Solo (Ant/Post), Avault Plus (Biosynthetic), Pelvitex Mesh *Bard Urology
    • Pinnacle (Anterior/Vault), Uphold (Vault), Polyform Mesh *Boston Scientific
    • Restorelle (Ant/Post), Restorelle (EzA) *Coloplast/Mpathy
    • Apogee (Post), Perigee (Anterior), Elevate Anterior, Elevate Posterior *American Medical Systems (AMS)
    • Posterior IVS *US Surgical
    • Ascend Anterior, Ascend Posterior *Caleda Medical
  • Slings
    • TVT *Gynecare
    • Sparc *AMS
    • Align *Bard Urology
    • Lynx, Advantage *Boston Scientific
    • IVS Tunneller *US Surgical
    • T Sling, Desara *Caldera Medical
    • TVT-O, TVT Abbrevo *Gynecare
    • Monarc *AMS
    • Align-TO, Uretex-TO *Bard Urology
    • Obtryx *Boston Scientific
    • Obtape *Mentor
    • T Sling, Desara-TO *Caldera Medical
    • Secur *Gynecare
    • MiniArc *AMS
    • Solyx *Boston Scientific
• Case Studies
  • TVT-type Sling Complications
    • TVT Sling – Urinary Retention, Lower Abdominal Pain
    • Sparc (TVT-type) Sling – Pain at the urethra
    • TVT Sling - Vaginal Extrusion
    • TVT (Lynx) - Leg, Vaginal Pain-Laparoscopic removal
    • Mesh in Bladder – Pain and Vaginal Bleeding
    • TVT Sling/Perigee Complication – Vaginal Bulge
    • TVT sling - Recurrent prolapse, persistent urinary leakage, mesh extrusion
    • TVT (Align) Sling and Posterior Avaulta Complication
    • TVT Sling Complication: Mesh Extruding Through Vaginal Epithelium
    • Vaginal Pain, Bloody Urine, Difficulty Walking Because of Lower Abdominal Pain
    • TVT Sling (Gynecare) – Pelvic Pain, Vaginal Pain, Painful Intercourse
  • TOT Sling Complications
    • Urinary Retention Following TVT-O Sling and Recurrent Prolapse
    • Leg and Groin Pain following TOT Sling
    • Leg Pain and Urinary Leakage
    • Vaginal Pain, Pain with sex
    • Pain and Urinary Leakage S/P Perigee and TOT Sling
    • Avaulta/TOT Sling Complication – Severe vaginal and buttock pain, pain w/ intercourse
    • TOT sling / Obtryx / Boston Scientific - Vaginal Pain
  • Mini Sling Complications
    • Complication of Mini Sling (Solyx-Boston Scientific, MiniArc Sling – AMS, Secure –Gynecare)
    • Complication of a Mini Sling (Ajust- Bard Urology)
  • Mesh Extrusion and Recurrent Prolapse
  • Posterior Wall Mesh Complications
    • Posterior Vaginal Wall Mesh – GyneMesh - Vaginal pain with intercourse
    • Posterior Vaginal Wall Mesh – Chronic Abscess/infection, Drainage from Buttock Cheek Tract
  • Prolift, Apo/Perigee Complications
    • Pain and Urinary Leakage S/P Perigee and TOT Sling
    • Vesicovaginal Fistula & Continuous Urine Leakage since Anterior Prolift Surgery for Cystocele
    • Chronic Abscess/Infection, Drainage from Buttock Cheek tract
    • Vaginal/Buttock Pain, Mesh exposure, Pain w/ Intercourse
  • Avaulta Complications
    • Pain with intercourse since Posterior Avaulta for Rectocele
    • Persistent Chronic Vaginal Pain since Posterior Avaulta for Rectocele
    • Vaginal and Buttock Pain Following Total Vaginal Mesh
    • Anterior Avaulta-Mesh Extrusion, Vaginal Pain
    • Avaulta/TOT Sling Complication – Severe vaginal and buttock pain, pain w/ intercourse
    • Chronic vaginal pain, vaginal mesh extrusion
  • UpHold Complications
    • UpHold Mesh Complication - Pain and Mesh Extrusion
    • UpHold Complication – mesh exposure, pain with intercourse (husband can feel mesh)
  • Sacral Colpopexy Mesh Complications
    • Sacral Colpopexy Mesh Extrusion (Gortex Mesh Graft)
    • Sacral Colpopexy Mesh Extrusion (Y-Mesh Graft)
    • Abcess post LAVH/Sacralcolpopexy
    • Sacral Colpopexy Mesh Abscess and Mesh Extrusion
    • Sacral Colpopexy Mesh Pain (Gynemesh Graft Removal)
• Scientific Papers
• Testimonials
• Blog
• Discussion Board
• Our Websites

Mesh Complication Case Study #5

Pain and Urinary Leakage S/P Perigee and TOT sling

Surgery: Perigee (AMS) vaginal mesh procedure for cystocele and TOT sling for SUI

Symptoms:  Vaginal pain, pelvic pain, pain with intercourse, urinary urgency/frequency

Treatment: Vaginal removal of anterior wall mesh and TOT sling

Patient is a 53-year-old woman from Denver, Co who had surgery for a cystocele (dropped bladder) and stress urinary incontinence (leaking with things such as laugh, cough, sneeze, exercise etc). She underwent a vaginal mesh procedure for her cystocele called a Perigee procedure (similar to Prolift Anterior, Pinnacle, Uphold, Avaulta) and a TOT sling for her stress urinary incontinence (SUI) in Arizona. The Perigee procedure is a first generation mesh kit that utilized trocars/needles passed through groin incisions and the obturator space to help place a mesh graft (Type I mesh) and anchor it with arms to the pelvic sidewall muscles. The TOT sling is a similar obturator approach (groin) where needles are passed through the groin to place a sub-urethral mesh tape sling to prevent SUI.

The patient had the above surgery 3 years ago and has been suffering from vaginal pain, pelvic pain, pain with intercourse (she could not have intercourse) and urinary symptoms of severe urgency, frequency and leakage with urge events (ie on the way to the bathroom).

She went to see her surgeon in Arizona many times after surgery and he/she kept telling her that there was nothing wrong and that she will get better with time. She subsequently moved to Colorado where she continued to have pain and problems and was referred to a prominent Urologist in Denver. He examined her and felt that the mesh was too tight and needed to be removed. He felt that this was a very complex operation and told her she needed to travel to Atlanta to have the surgery done.  He does complete the mesh repairs for prolapse, and is a very advanced surgeon, however felt that removal of mesh was beyond the scope of his expertise or anyone in the region. He said, “there is only one surgeon in the US that I would recommend do your surgery and that is Dr. Moore in Atlanta, Georgia”.

The patient travelled from Denver to Atlanta to see Dr. Moore and Miklos and on her exam was found to have extreme pain on exam and could barely tolerate any type of vaginal exam at all. It was found that the mesh arms from the Perigee graft AND the TOT sling were all too tight, under tension and when palpated caused extreme pain to the patient. She was also found to have urinary obstruction type symptoms from the mesh and the sling. She was taken to surgery the following day and had the mesh graft and sling released and removed. She recovered well and travelled back to Colorado a few days after surgery and had less pain after surgery than she has had in over 3 years! She subsequently has done very well and has undergone pelvic floor physical therapy to continue to treat her symptoms and help resolve any lingering symptoms.

Please click here for more information on TOT Sling Complications.

Mesh Surgeons Home