Management of Mesh Complications after SUI and POP Repair: Review and Analysis of the Current Literature

Abstract

Purpose. To evaluate the surgical treatment concepts for the complications related to the implantation of mesh material for urogynecological indications. Materials and Methods. A review of the current literature on PubMed was performed. Results. Only retrospective studies were detected. The rate of mesh-related complications is about 15–25% and mesh erosion is up to 10% for POP and SUI repair. Mesh explantation is necessary in about 1-2% of patients due to complications. The initial approach appears to be an early surgical treatment with partial or complete mesh resection. Vaginal and endoscopic access for mesh resection is favored. Prior to recurrent surgeries, a careful examination and planning for the operation strategy are crucial. Conclusions. The data on the management of mesh complication is scarce. Revisions should be performed by an experienced surgeon and a proper follow-up with prospective documentation is essential for a good outcome.

Prospective long-term results, complications and risk factors in pelvic organ prolapse treatment with vaginal mesh

“…Currently, over 30.000 cases due to mesh-related complications and law suits on several manufacturers have been brought before the US courts. Reacting to this, several products have been withdrawn from the market by the manufacturers [11,31].…”

Results of collagen sling placement following the partial removal of a synthetic midurethral sling

“…The results showed an overall postoperative continence rate of 28%, with a maximum cure rate of 45% in the group with both erosion and displacement of the primary sling. A review of the current literature on the management of mesh complications after SUI and pelvic organ prolapse surgery describes a 20% recurrence of SUI after transvaginal MUS excision [20]. Although the concomitant placement of a second sling should theoretically enhance continence after primary sling removal, this was not observed in the present study.…”

FPMRSChallenges on behalf of the Collaborative Research in Pelvic Surgery Consortium (CoRPS): managing complicated cases

“…In limited studies, the rate of vaginal mesh or suture erosion after abdominal sacrocolpopexies is cited as 4.2-10% [4,5], but there is limited literature regarding recommendations between partial vs. complete resection of the mesh. Most of the existing information is based on transvaginal mesh and is from either case series or retrospective cohorts [6]. In a retrospective mixed cohort of women who had transvaginal mesh, sacrocolpopexies, and miduretheral slings from The Netherlands evaluating partial vs. complete mesh resection, those who underwent complete resection had a higher rate of complications and prolapse recurrence with no difference in relief of symptoms between partial and complete excision [7].…”