Mesh Complications Patient Story 9
Pain with intercourse post Rectocele Repair with Vaginal Mesh
Mesh Complications: Vaginal pain with the inability to have intercourse secondary to extreme pain
Treatment: Posterior wall mesh removal, release of mesh arms under tension and revision of rectocele
The patient is a 56 -year- old woman who underwent an Avaulta (Bard Urology) vaginal mesh procedure for a rectocele three years ago. The patient reported painful intercourse since her surgery.
The Avaulta is very similar to the Posterior Prolift, the Apogee and the Posterior IVS. This first generation mesh kit utilizes trocars /needles. The trocars are passed through the buttock cheeks, and the ischiorectal space to place the mesh graft (Type I mesh) and to anchor two arms to the pelvic sidewall muscles. It is also anchored to the perineal muscles with two arms. These arms are brought through the perineal muscles through the buttock incisions. It is the only kit that utilizes this type of attachment to the perineum. The Avaulta mesh is sometimes coated with porcine collagen, which is thought to reduce inflammatory reaction, however, in some animal studies it has actually increased reaction. It is also a somewhat heavy and dense mesh compared to newer mesh.
The patient chose to visit Drs. Moore and Miklos in Atlanta, GA based on their extensive mesh research as well their experience with complicated mesh cases. Examination of the patient revealed the mesh was gathered in the mid-portion of the vagina creating ridges. When the physician palpated these ridges, this caused the patient extreme pain.
The patient was taken to surgery the following day and had the mesh graft removed and the rectocele repair revised. In follow-up, her pain had resolved, and she is able to have pain-free sex. Her rectocele remains cured.
Mesh Patient Testimonial
“Dr. Moore was extraordinary. He really cares about his patients. During my consultation he reviewed a research paper written by him regarding my complications and my procedure. I knew then I wanted to have my surgery done by a doctor who teaches and educates others in this field. Since my surgery, I feel so much better and I am very pleased with my progress. Dr. Moore and everyone at his practice were wonderful.”
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