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

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Mesh Complication Case Study #6

Sacral Colpopexy Mesh Extrusion-2010 (Gortex Mesh Graft)

Surgery: Vaginal approach to sacral colpopexy mesh removal

Symptoms: Bloody vaginal discharge, Extruding vaginal mesh, Pain with intercourse

Treatment: Vaginal removal of entire Goretex graft up to the tailbone

Patient is a 72 year old female who has a history of multiple reconstructive vaginal surgical procedures over the last 40 years.  She had the following surgical procedures:

• 1970 – Uterine suspension for uterine prolapse
• 1980 – Hysterectomy for uterine prolapse
• 1988 – Sacral Colpopexy (Gortex Mesh), Paravaginal repair, Enterocele repair
• 1989 – Posterior repair
• 1990's – Anterior repair
• 2004 – Anterior repair (w/Perigee Mesh), Posterior repair
• 2010 – Removal of Gortex Sacral Colpopexy Mesh (performed in 1988)

The patient presented with the above symptoms and exam revealed complete extrusion of the mesh through a perforation at the apex of the vagina. (Please see picture below) The mesh was still attached to the patient’s tailbone.  She was taken to surgery and we were able to remove the complete mesh (IN THIS CASE) via the vagina.   This patient did not require a single incision in the abdomen.  This patient has a unique situation which could be fixed by a vagina-only approach.  What also makes this unique is that the mesh of the sacral colpopexy worked for 22 years, supporting the vaginal vault (apex) before there was a problem. 

Please note that the patient’s support of the bladder is doing well 7 years after her mesh anterior wall fixation using the AMS mesh surgery known as Perigee.  Gortex mesh was a commonly used mesh in the 1980-1990’s.  It is not considered the best material for sacral colpopexy reconstruction in 2010.

Please click here for more information on Sacralcolpopexy Mesh Complications.

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