Dr Miklos and Moore performed a complete surgical removal of TOT sling (Obtryx – Boston Scientific) from a patient suffering from mesh complications. The patient described her mesh complications as: an allergic reaction to the mesh as well as vaginal, groin and pelvic pain.
A 50-year-old woman who had undergone a TOT mesh sling (FIGURE #1) for cough urine leakage only 8 days prior presented to Dr Miklos & Moore for complete TOT sling removal for mesh complicatiions. She presented with mesh complications including: pelvic, vaginal, groin and radiating left leg pain, vaginal pressure and numbness as well as what she believes to be is an allergic reaction to mesh. She describes the allergic reaction as a rash especially to the face, numbness and tingling of the mouth, lips and tongue. (FIGURE #2)
She attributes the allergic type symptoms to the Obtryx TOT sling as she claims to have had a similar reaction after the placement of her laparoscopic banding procedure (for weight loss) in 2010. At that time, she underwent multiple medical workups to rule out any underlying medical causes including: lupus and dermatologic problems (such as: dermatitis, psoriasis, eczema,) — which were proven negative.
Her symptoms persisted until 2018 when her gastric banding surgeon recommend she have the gastric band removed. She claims that within one week of having the band removed her allergic symptoms went away and she did not have a recurrence of these symptoms until the day after having the TOT mesh implanted.
Dr Miklos performed a physical exam which confirmed excessive pain in the vagina and the obturator (groin) muscle area where the sling was placed. The exam also confirmed a fascial rash. After an informed consent, the patient elected to proceed with a complete TOT mesh sling removal for her mesh complication.
100% mesh removal — TOT mesh sling
The surgery was 1.5 hours in length and was performed without complication and with only a blood loss of 1 tablespoon. The complete TOT sling was removed a total of 24 cm of mesh. (FIGURE 3) The patient felt that her symptoms of tongue and mouth tightness as well as her pelvic pain was dramatically diminished the next morning. She was elated that her mesh complications could be resolved by the complete removal of her TOT sling,
Figure 1 – TOT sling position
Figure 2 – Face Rash
Figure 3 – Photo of 24 cm of TOT mesh