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Mesh Complications / Removal

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Surgical mesh is used as a way to treat issues related to pelvic organ prolapse or stress urinary incontinence, and other pelvic floor disorders. When healed properly, mesh slings can be an incredibly effective surgical intervention, leading to improved symptoms and improved quality of life. While surgical mesh can be a life-changing tool for many women, it does carry the risk of complications down the line. Dr. Darren Lazare performs surgery to remove surgical mesh that has been affected by a complication, like exposed mesh, helping to further correct issues of prolapse or incontinence and restore comfort.

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WHAT ARE THE TYPES OF MESH COMPLICATIONS?

Between 6 and 12% of women who have undergone pelvic mesh surgeries experienced complications directly related to the mesh.

Mesh complications can cause mild to severe pain and can include the following complications:

    • Vaginal mesh exposure or mesh erosion

      Erosion into other organs

    • Vaginal mesh contraction/shortening

    • Pain during sex

    • Infection

    • Bleeding

    • Return of prolapse

Dr. Lazare and his team were amazing. They were supportive and helpful. The surgery I had went smoothly and the results were exactly as I had hoped. I definitely recommend Dr. Lazare!

Kristen G.

Dr. Lazare is a gifted surgeon, who was patient and listened to every concern that I had. When I left, I felt that we were on the same page and that my surgery would be a success. I was right! I could not be more delighted with the results of my surgery. I would not hesitate to refer Dr. Lazare to anyone I know or met. If I could give him more stars I would!

Anonymous

I cannot begin to express how delighted I am with the decision I made in choosing Dr. Lazare as my surgeon. The entire experience from beginning to end has been superb. His office staff are professional, helpful and friendly.

Julia M.
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In the event that you are experiencing mesh complications, Dr. Lazare performs the following mesh revision surgeries to help correct the complications.

TVT Sling Removal

This form of mesh can be removed in a small section or completely removed. The mesh excision process involves a combined vaginal and abdominal procedure. Through the vaginal incision, the mesh is identified, separated into small sections, and carefully removed from the tissue of the urethra and areas as far back as the pubic bone. Through the abdominal incisions, the mesh behind the pubic bone is accessed and skillfully removed. Mesh removal behind the pubic bone requires a hospital stay of one or two nights.

TOT Sling Removal

TOT slings, also called transobturator slings, are inserted into an incision made in one side of the groin, then threaded toward the vagina to support the urethra. The mesh is then guided out of an incision made on the other side of the groin. Complete removal of a TOT sling is done through an incision in the vagina and on either side of the groin. Once identified, the mesh is divided into smaller sections and carefully removed from the urethra and surrounding tissue. Complete removal of mesh from the obturator and groin muscles and be difficult as the mesh is sometimes hard to find. TOT sling removal requires a hospital stay of two to four days.

Transvaginal Mesh Removal

Transvaginal mesh removal is an all-encompassing term to describe the surgical process of removing surgical mesh that has been implanted via the vagina. Because transvaginal mesh is considered a permanent procedure, the removal can sometimes be difficult. Removal may include incisions in the vagina and groin or vagina and abdomen.

Sacrocolpopexy Mesh Removal

Sacrocolpopexy mesh removal starts with an incision in the vaginal wall or abdominal wall, depending on the location of the mesh. Dr. Lazare carefully dissects the tissues surrounding the mesh to access and remove it while avoiding the surrounding tissue as much as possible. In some cases, the mesh may be cut into smaller pieces for easier removal.

Mesh Removal Recovery

Depending on the specifics of your operation, mesh removal recovery may require an overnight hospital stay of up to four days. Immediately after your surgery, you may experience discomfort, swelling, and fatigue, which can be managed with pain medication and adequate rest. Your provider will restrict you to activities such as heavy lifting and strenuous exercise. Follow-up appointments with Dr. Lazare are essential for monitoring the healing progress and addressing any concerns. While some improvement in symptoms may be noticeable shortly after surgery, complete recovery often takes several weeks to months, depending on the extent of the procedure and individual healing responses. Pelvic floor exercises and other rehabilitative measures may be recommended to support recovery and optimize outcomes.

Schedule a Consultation

To learn more about mesh complications and mesh removal surgeries and to determine whether you qualify for this procedure, schedule a consultation with Dr. Darren Lazare today. You can also head to our website to fill out an online contact form and get in touch with a member of our team.

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Candidates for Mesh Removal

The ideal candidate for mesh removal is someone experiencing persistent or worsening symptoms related to pelvic mesh complications, such as pain, discomfort, urinary or bowel dysfunction, recurrent infections, or mesh erosion. Candidates should have undergone previous pelvic mesh implantation and be medically stable for surgery so as not to increase surgical risks. Additionally, they should have realistic expectations regarding the outcomes of mesh removal and be open to the recovery process.

FREQUENTLY ASKED QUESTIONS

You Have Questions, We Have Answers.

What are the most common complications associated with mesh surgery?

The most common complications of mesh surgery include pain, infection, mesh erosion, or the recurrence of the original condition. These complications can vary in severity and may require additional medical intervention.

How long does it take to recover from surgery to address mesh complications?

Recovery time from surgery to address mesh complications varies depending on the type and extent of the complications, as well as individual healing factors. Patients may experience discomfort, swelling, and restricted activity for several weeks post-surgery, with full healing occurring over several months.

Can mesh complications be treated non-surgically?

In some cases, mild mesh complications may be managed non-surgically with medication, physical therapy, or lifestyle modifications. However, more severe complications, such as mesh erosion or infection, often require surgical intervention to resolve.

What steps can be taken to prevent mesh complications?

The best way to prevent mesh complications is by choosing a highly skilled and experienced surgeon like Dr. Darren Lazare. Additionally, close postoperative monitoring and prompt intervention in case of complications can help mitigate risks and optimize outcomes.

Can mesh complications occur long after surgery?

Yes, mesh complications can develop not only shortly after the surgery but also years later. Issues such as chronic pain, mesh migration, and organ perforation may manifest long after the initial procedure, making it challenging to associate these symptoms with the earlier surgery. Regular follow-ups with healthcare providers are essential for monitoring any potential late-onset complications.

What are the signs that I might be experiencing a mesh complication?

Signs of mesh complications can include persistent pain in the pelvic region, urinary problems (such as incontinence or difficulty urinating), vaginal discomfort or scarring, and unusual discharge. Other symptoms may involve bowel issues or gastrointestinal problems if the mesh has migrated or caused perforation. If any of these symptoms arise, it is crucial to consult a healthcare provider promptly.

Is surgery always required to address mesh complications?

Not always. While some mesh complications may necessitate surgical intervention, many can be managed conservatively through non-surgical treatments. Options include physical therapy, medications for pain relief, and topical treatments for vaginal discomfort. The approach depends on the severity of the symptoms and the specific complications experienced by the patient.

How are mesh complications diagnosed?

Diagnosis of mesh complications typically involves a thorough medical history review and physical examination by a healthcare provider. Imaging studies such as ultrasounds or MRIs may be used to assess the position of the mesh and identify any associated issues. In some cases, endoscopic evaluations may be necessary to visualize internal structures and confirm complications.

What should I do if I suspect I have a mesh complication?

If you suspect you have a complication related to mesh surgery, it is important to seek medical advice promptly. Consult your healthcare provider to discuss your symptoms and undergo appropriate evaluations. They can help determine whether your symptoms are related to the mesh and recommend an individualized treatment plan based on your specific situation .

How long does the transvaginal mesh removal surgery take?

The duration of the surgery can vary based on the extent of the mesh erosion and individual circumstances. Simple cases may take less than 30 minutes, while more complex removals involving significant tissue repair can take several hours. On average, most procedures last between 30 minutes to a few hours.

What is the recovery process like after transvaginal mesh removal?

Recovery time after transvaginal mesh removal can range from a few weeks to several months, depending on the complexity of the surgery. Patients may experience some pain, minor bleeding, and discomfort during recovery. Most individuals can return to light activities within 1 to 2 weeks but should avoid strenuous activities and sexual intercourse for at least six weeks.

Are there risks associated with transvaginal mesh removal?

Yes, like any surgical procedure, transvaginal mesh removal carries risks. Potential complications include infection, bleeding, damage to surrounding organs (such as the bladder or rectum), and persistent pain. Additionally, there is a possibility of recurrence of symptoms related to urinary incontinence or pelvic organ prolapse after removal.

How effective is transvaginal mesh removal in alleviating symptoms?

Many patients experience significant relief from symptoms after transvaginal mesh removal. Studies indicate that approximately 51% of patients report complete resolution of symptoms following the procedure, while others may experience improvement in pain and discomfort. However, some individuals may continue to have persistent issues, particularly if they had pre-existing conditions before the mesh placement.

What is sacrocolpopexy mesh removal?

Sacrocolpopexy mesh removal is a surgical procedure aimed at excising synthetic mesh that was previously implanted during a sacrocolpopexy surgery to treat pelvic organ prolapse. This procedure is necessary when complications arise, such as mesh erosion, chronic pain, or recurrent prolapse symptoms.

What are the indications for sacrocolpopexy mesh removal?

Indications for mesh removal include persistent symptoms such as vaginal bleeding or discharge, pain during intercourse, and significant erosion of the mesh into surrounding tissues. Additionally, if conservative treatments fail to alleviate these symptoms, surgical intervention may be warranted to improve the patients quality of life.

How is the sacrocolpopexy mesh removal procedure performed?

The procedure can be performed using either an open abdominal approach or laparoscopic techniques, depending on the complexity of the case and the extent of the mesh erosion. The surgeon carefully identifies and removes the mesh while addressing any adhesions or complications that may have developed due to the previous surgery.

What is the recovery time after sacrocolpopexy mesh removal?

Recovery time can vary based on the surgical approach used and individual patient factors. Generally, patients can expect a recovery period of about six to eight weeks. During this time, they may need to avoid heavy lifting and sexual activity while following post-operative care instructions from their healthcare provider.

Are there risks associated with sacrocolpoxy mesh removal?

Yes, as with any surgical procedure, there are risks involved in sacrocolpopexy mesh removal. Potential complications include infection, bleeding, damage to surrounding organs (such as the bladder or rectum), and recurrence of prolapse symptoms. It is essential for patients to discuss these risks with their healthcare provider before undergoing the procedure.

Dr. Arko Demianzuk

Dr. Darren Lazare

Restorative Gynecology Surgeon | BLOG

Dr. Darren Lazare received his residency training in Obstetrics and Gynaecology at the University of British Columbia. He successfully completed his subspecialty fellowship training in female pelvic medicine and reconstructive surgery at the University of Alberta. Dr. Lazare has been appointed as a Clinical Associate Professor at the University of British Columbia where he is the residency supervisor for the urogynecology program. He is a Surgeon Champion for the American College of Surgeon’s National Surgical Quality Improvement Program (NSQIP). He is a committed advocate for women’s health, medical education and quality improvement initiatives while maintaining a full clinical, reconstructive and cosmetic practice. Dr. Lazare’s professional memberships include the Royal College of Physicians and Surgeons, the Canadian Society of Pelvic Medicine, the International Urogynecology Association, the International Continence Society and the American Urogynecology Society.

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