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Surgically Treated over 400 Mesh Complications in 2012
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Mesh Complications Patient Story 59

Vaginal Pain, Painful Sex, Lower Back Pain, Mesh Extrusion, & Difficulty Evacuating Bowels following a Mesh Repair with Sacrospinus Ligament Fixation

Mesh Complications: Pain with sitting, lower abdominal pain and after rectal exams. Pain with defecation and pain in vagina.

Treatment: Posterior and Anterior repair and rectal wall mesh removal

The patient is a 40-year-old woman who had her surgery performed at a major University in Atlanta. She initially had surgery for a rectocele and difficulty evacuating her rectum. The surgeon used mesh to reinforce the rectocele repair but then sutured the deepest part of the mesh to the sacrospinous ligaments on each side of the vagina.

Dr. Miklos Note: Sacrospinous ligament (SSL) suspensions are an acceptable operation for the treatment of vaginal vault prolapse but not just for a rectocele by itself. It is assumed she had vault prolapse. The gold standard operation for vault prolapse is the sacral colpopexy.

After the surgery, the patient claims that she had vaginal pain as well as pain in her right leg. She also points to her coccyx (i.e. the very end of her tailbone) as a point of tenderness. She suffered with the pain for three years before her primary surgeon suggested removing the mesh. She was taken to the operating room and most of the mesh was removed but the sutures and point of mesh attachment to the ligaments were not. A year later the surgeon took her back for another surgery for mesh removal and told her "I did all I can do for you," and removed even more mesh.

She came to see Drs. Miklos & Moore for further evaluation for her continued pain. She was ultimately taken to the operating room where she had the sutures on her RIGHT side removed (Figure 1 & 2) as well as, the mesh and attaching suture from the LEFT sacrospinous ligament (Figure 3, 4 & 5).

Dr. Miklos Comment: Patients are often told that sutures cannot be removed from the sacrospinous ligament (SSL), but this is simply not true. They can be removed, but the surgery is difficult and meticulous in nature. A surgeon should warn the patient of all potential risks of this surgery prior to removal.

Since the surgery, the patient has noted an improvement in pain. It is recommended that now all the insulting mesh is removed that now she sees a physical therapist for further therapy.

 

Photo 1
Figure 1 - Removal of sutures from the Right side of the Sacrospinous Ligament
Photo 2
Figure 2 - Removal of sutures from the Right side of the Sacrospinous Ligament
Photo 3
Figure 3 - Right Groin incision where the mesh and attaching suture from the Right sacrospinous ligament was removed

Photo 4
Figure 4 - Removed Suture from Right sacrospinous ligament
Photo 5
Figure 5 - Removed Mesh from Right sacrospinous ligament


Click here to find out more about Sacrospinous Ligament With and Without Mesh complications.

Click here to find out more about Posterior Wall Mesh complications.

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