TOT Mesh Complication – Pain | TOT Mesh Removal and Adhesiolysis for Pelvic Pain
A patient from North Carolina came to consult with Drs. Miklos and More regarding her vaginal pain after getting a TOT sling for stress urinary incontinence. She also had lower abdominal pain and a long-standing history of intra-abdominal adhesions. In 2018 the patient had adhesion surgery in Germany by world renowned surgeon Dr. Daniel Kruschinski. Dr. Kruschinski has a wonderful reputation as a surgeon and is an old friend of Dr. Miklos. They had previously operated together in Moscow Russia.
Her pain initially improved but over time the pain in right upper and lower abdomen returned due to adhesion reformation. In 2022 she chose Drs. Miklos & Moore for her surgery due to their expertise in adhesions and mesh removal surgery specifically.
The patient was seen by Dr. Miklos who diagnosed her with recurrent intrabdominal adhesions as well as vaginal pain due to TOT mesh sling. After an informed consent the patient elected to have both a laparoscopic adhesiolysis as well as a transvaginal approach to mesh removal.
Dr. Miklos only removed the vaginal portion of the sling as the patient only had vaginal pain, if the patient suffered from groin pain, he would have also recommended removing the arms of the sling traversing the obturator interus and externus muscle (a much more complex surgery). The patient’s surgery was performed in less than 90 minutes with minimal blood loss and without complications.
The patient spent the evening in the hospital and 1 more day in Atlanta and then returned to North Carolina. Miklos & Moore have removed more than a thousand pieces of mesh in their career with minimal complications. They are honored that this patient chose to come to Atlanta despite having the choice of traveling back to Germany for her surgery. Thank you, Ms. B, for entrusting your care with us.