Drs. Miklos & Moore are world-leading experts in vaginal mesh complication surgery. Here they are featured on the internationally syndicated TV show.
Transvaginal mesh (TVM) complications can manifest themselves in a variety of ways, but the pain and suffering is a common denominator for affected women. At Miklos & Moore, we pride ourselves on accurately diagnosing the cause of discomfort and utilizing the least invasive technique possible to remove the mesh and provide relief.
Transvaginal mesh implants have been used for prolapse repair of the anterior vaginal wall (bladder), posterior vaginal wall (rectum) and the vaginal vault (deepest point of the vagina) since the mid-2000. A number of surgical companies developed transvaginal mesh kits in an attempt to make prolapse surgery easier for the average surgeon. However many of these mesh kits were not appropriately studied prior to their release for surgical use and unexpected complications have occurred. Unfortunately some of these complications are severe, unrelenting, and chronic in nature.
Drs. Miklos and Moore have presented the WORLD’S LARGEST STUDY on the surgical treatment of mesh complications at the most important national and international urogynecologic meetings in the world.
The complications encountered with TVM are very similar to the complications encountered with other mesh like the slings or the sacrocolopopexy. The most common complications include: pelvic and vaginal pain, pain with intercourse, meshes extruding through the skin of the vagina, vaginal discharge, vaginal bleeding, and recurrent urinary tract infections, mesh infections, and mesh abscesses.
Often the pain, discomfort and other symptoms are found along the points of insertion and the pathway of the TVM. Symptoms primarily associated with the anterior TVM include: urethral obstruction, urine retention, pain with urination, mesh erosion into urethra and bladder, groin pain and leg pain. Symptoms primarily associated with the posterior TVM include: pain with defecation, difficulty evacuating ones rectum, mesh erosion into the rectum, buttocks pain and perineal pain. Examples of mesh complications are seen in the medical illustrations below.
Patients presenting with mesh extrusion through the vaginal skin can have any of the above mentioned symptoms but will often have bloody, clear or yellow discharge, pain with sex and a rough area in the vagina consistent with mesh coming through the skin.
This treatment usually requires removing the extruding portion of mesh or the whole body of mesh, in the area affected, and leaving the arms behind. This is done with a single incision performed through the vaginal opening.
Patients receiving mesh with arms (seen above) can have more problems not only with the body of the mesh but also with the associated arms of mesh that are anchored into the pelvic muscles. Quite often the mesh can scar too tightly and create severe tension between the muscles of the pelvic floor. This often results in vaginal pain, pelvic pain and pain with sex.
Anterior vaginal wall mesh, which is placed under the bladder, usually has arms that penetrate the groin and are more likely to have groin pain along with vaginal pain and pain with sex.
Posterior vaginal wall mesh, which is placed over the rectum, usually have arms that penetrate the buttock and are more likely to have deep seated pelvic and buttocks type pain.
Patients with deep-seated pain due to severe vaginal scarring are best treated with removing as much of the mesh as possible as soon as possible. The longer the mesh remains in place the greater inflammatory reaction and scar formation resulting in long term nerve damage. This surgery is performed through a single anterior and single posterior vaginal wall incision through the opening of the vagina removing the largest portion of the mesh known as the body and leaving the arms behind.
Anterior vaginal wall (bladder) mesh can also erode into the bladder or urethra. This will often cause vaginal/pelvic pain, pain with sex, blood in urine and pain, recurrent urinary tract infections and pain with urination.
Posterior vaginal wall (rectum) mesh can erode into the rectum. This can cause vaginal/pelvic pain, pain with sex, bloody and painful bowel movements.
Erosion complications are some of the hardest complications to treat, see Drs. Miklos & Moore’s Award Winning Video to the right.