WHAT ARE THE SYMPTOMS / PROBLEMS OF PARTIAL MESH REMOVAL?

When people and surgeons talk about pelvic mesh, they are usually talking about mesh which was used to support the bladder, rectum, uterus or the vaginal vault (the deepest 25% of the vagina).  When they talk about mesh slings, they more commonly use the term” sling” including TVT slings, TOT slings, single incision slings.  For the purpose of this writing, we referring to, sacralcolpopexy, anterior mesh, posterior mesh and vaginal vault mesh.

When Dr Miklos makes a decision to remove just a portion of the anterior vaginal wall mesh, posterior vaginal wall mesh or sacralcolpopexy, iti is usually because he just wants to treat what is bothering the patient by removing the insulting portion of the mesh creating the symptoms and leave the rest of the mesh to potentially maintain support.

Though each of the symptom/signs list below are complications of the mesh, the mesh symptoms/signs that are usually treated with partial mesh removal are denoted with **:

Chronic Pain– is one of the most common & most devastating complications of transvaginal mesh surgery. This can be caused by nerve damage, mesh erosion into neighboring organs such as: bladder, urethra, rectum, small or large bowel or most commonly the vaginal skin or excessive scar tissue which can pull on nerves resulting in pain.

**Painful sex – the mesh can cause painful intercourse for the patient and / or her partner. Again, the scar tissue can cause pain by tension on nerves or exposure, extrusion, or erosion of mesh. (FIGURE1 & 2)

Infection- which may result in tissue or organ wall infection which can manifest as a symptom of pain, fever, discharge.

**Mesh exposure -transvaginal mesh can become exposed so one can see the mesh coming through the vaginal skin, but it does NOT protrude beyond the height of the skin., this can cause pain or painful intercourse for the patient and her partner as well as bleeding and infection.

**Mesh extrusion – mesh is exposed through the skin but is protruding above or beyond the borders of the skin. (FIGURE1 & 2)

Mesh erosion – is like mesh exposure however instead of the mesh migrating or being seen on the outside i.e., as a disruption in the skin of the vagina one would see the mesh penetrating the inside of a neighboring organ such as the urethra, bladder, or rectum.  When this happens common signs or symptoms include pain, bleeding, infection, painful intercourse or potentially blood in the urine or in the feces and pain during urination or defecation.

Urinary problems – may include:

  • complete urine retention,
  • inability to empty one’s bladder,
  • urgency
  • frequency
  • overactive bladder
  • recurrent urinary tract infections
  • urinary incontinence.

FIGURE 1: Anterior vagnial wall mesh extrusion and pain. Patient is to have this area of the anterior wall mesh removed.

FIGURE 1:
Anterior vagnial wall mesh extrusion and pain. Patient is to have this area of the anterior wall mesh removed.

FIGURE 2: Sacralcolpopexy mesh extrusion and pain. Patient to have this area of the sacralcolpopexy removed.

FIGURE 2:
Sacralcolpopexy mesh extrusion and pain. Patient to have this area of the sacralcolpopexy removed.

If you are experiencing any of these signs or symptoms after undergoing mesh surgery, it is important to consult with an experienced mesh removal surgeon or healthcare provider for proper evaluation and treatment.  All too often patients are having mesh failures inappropriately evaluated or even treated.  Failure to remove the mesh appropriately can lead to further complications and worsening conditions as well as making the remainder of the mesh even more difficult to find and remove in future surgery.

WHY CHOOSE MIKLOS & MOORE UROGYNECOLOGY FOR (Partial) MESH REMOVAL?

Partial mesh removal requires the least amount of training or skill to perform. This is shall we say the simplest of the surgeries of mesh removal apart from the partial sacralcolpopexy mesh removal.  Patients choose Dr Miklos because of his:

EXPERIENCE -First and foremost at Miklos & Moore Urogynecology the doctors listen.  They have been removing mesh since 1998 and have seen, treated, or removed just about every type of mesh complication known to man.  They have removed more than 1000 pieces of mesh with minimal complications and superior success.

EXPERTISE – They have treated patients from all over the world for mesh complications.  They have produced award winning videos which have gotten them international acclaim for their mesh removing technique.  They have minimal complications.

  • Total Sacralcolpopexy mesh removal
  • Total TOT sling removal
  • Total Posterior and Anterior wall mesh removal including Arms through the buttocks or obturator space.
  • Removed Mesh form the rectum and bladder and repair the defect (VIDEO 1)
  • Removed mesh and repaired sinus tracts from the sacrum to the vagina, from mesh to buttocks and peri anal area.

KNOWLEDGE – They are Rule 26 medical legal experts who understand the law and malpractice cases facing patients today.  They are also leaders in the world on mesh complications as they have written some of the largest papers on mesh complications found in the worldwide literature.

RESULTS – Miklos & Moore Urogynecology have addressed and removed mesh from some of the most difficult cases such as:

 


Video 1– Transvaginal Mesh Removal

RECOVERY TIME AFTER MESH REMOVAL SURGERY?? 

Recovery time is dependent upon the amount of mesh removed, the location of the removal as well whether concurrent reconstructive surgery was performed at the time the mesh was removed.   In general, is the patient is just getting mesh removal the patient is free to return to normal activity in 6 weeks.

However, if a patient is getting mesh removal and is going to have reconstructive surgery at the time of mesh removal, most likely their recovery will take 12 weeks.  This does not mean the patient will have pain the whole time, what it means is the reconstructive surgery will need time to heal and scar in place.