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Updated: May 31, 2026
Transvaginal Mesh Insertion in the Ovine Model
Published on: July 27, 2017
Surgical management of mesh-related complications after prior pelvic floor reconstructive surgery with mesh
Myrthe M Tijdink1, Mark E Vierhout, John P Heesakkers
1Department of Obstetrics and Gynaecology 791, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, the Netherlands. myrthetijdink@hotmail.com
Introduction And Hypothesis:
The objective of this study is to evaluate the complications and anatomical and functional outcomes of the surgical treatment of mesh-related complications.
Methods:
A retrospective cohort study of patients who underwent complete or partial mesh excision to treat complications after prior mesh-augmented pelvic floor reconstructive surgery was conducted.
Results:
Seventy-three patients underwent 30 complete and 51 partial mesh excisions. Intraoperative complications occurred in 4 cases, postoperative complications in 13. Symptom relief was achieved in 92% of patients. Recurrence of pelvic organ prolapse (POP) occurred in 29% of complete and 5% of partial excisions of mesh used in POP surgery. De novo stress urinary incontinence (SUI) occurred in 36% of patients who underwent excision of a suburethral sling.
Conclusions:
Mesh excision relieves mesh-related complications effectively, although with a substantial risk of serious complications and recurrence of POP or SUI. More complex excisions should be performed in skilled centers.
Insights
Surgical mesh excision effectively treats mesh complications, but carries risks of recurrence for pelvic organ prolapse (POP) and stress urinary incontinence (SUI). Complex procedures require specialized centers for optimal outcomes.
Area of Science:
- Urology
- Gynecology
- Surgical Innovation
Background:
- Mesh-augmented pelvic floor reconstructive surgery is common.
- Mesh-related complications can significantly impact patient quality of life.
- Surgical intervention is often necessary to address these complications.
Purpose of the Study:
- To evaluate the outcomes of surgical mesh excision for mesh-related complications.
- To assess anatomical and functional results post-excision.
- To identify complication rates and recurrence risks associated with mesh removal.
Main Methods:
- Retrospective cohort study.
- Inclusion of patients undergoing complete or partial mesh excision.
- Analysis of intraoperative and postoperative complications, symptom relief, and recurrence rates.
Main Results:
- Seventy-three patients underwent mesh excision (30 complete, 51 partial).
- Symptom relief was achieved in 92% of patients.
- Recurrence of pelvic organ prolapse (POP) occurred in 29% (complete) and 5% (partial) excisions. De novo stress urinary incontinence (SUI) occurred in 36% of suburethral sling excisions.
Conclusions:
- Mesh excision is an effective treatment for mesh-related complications.
- Significant risks of recurrence (POP, SUI) and serious complications exist.
- Complex mesh excisions necessitate performance in experienced, specialized surgical centers.
