Mesh removal following transvaginal mesh placement: a case series of 104 operations.

INTRODUCTION AND HYPOTHESIS: The objective of the study was to reveal the way we treat vaginal mesh complications in a trained referral center.

METHODS

This is a retrospective review of all patients who underwent surgical removal of transvaginal mesh for mesh-related complications during a 5-year period.

RESULTS

Eighty-three patients underwent 104 operations including 61 complete mesh removal, 14 partial excision, 15 section of sub-urethral sling, and five laparoscopies. Main indications were erosion, infection, granuloma, incomplete voiding, and pain. Fifty-eight removals occurred more than 2 years after the primary mesh placement. Mean operation time was 21 min, and there were two intraoperative and ten minor postoperative complications. Stress urinary incontinence (SUI) recurred in 38% and cystocele in 19% of patients.

CONCLUSIONS

In a trained center, mesh removal was found to be a quick and safe procedure. Mesh-related complications may frequently occur more than 2 years after the primary operation. Recurrence was mostly associated with SUI and less with genital prolapse.