1) Mesh Extrusion or exposure vaginally after Vaginal Mesh Surgery:
This is the most common complication after Vaginal Mesh Surgery. It is typically considered a minor complication and one that is taken care of relatively easily with a minor surgical procedure. Mesh technology has improved and recent studies using lighter mesh has shown the extrusion rate has dropped more than 50% in some cases. This also has to do with improved surgical technique and surgeon experience as well.
When a mesh extrusion occurs, it will cause bleeding or pain and may have vaginal discharges. Conservative therapy such as antibiotics and/or estrogen cream may be used with early extrusions. A minor procedure involving excising or trimming the exposed mesh and repair of the defect is necessary when there is a large exposure of the mesh or when there is no healing.
2) Mesh Erosion into the bladder or rectum after Vaginal Mesh Surgery:
If mesh erosion occurs it will require surgical management. Symptoms can include bladder pain, blood in the urine, frequent urinary tract infections, voiding dysfunction (urgency, frequency, painful urination, etc.), fistula formation (drainage of urine or feces into the vagina), bloody stools, abscess formation, rectal pain, or other symptoms including systemic infection. This is a serious complication and requires surgical intervention.
3) Vaginal, leg and/or buttock pain after Vaginal Mesh Surgery:
This complication can occur if the mesh is placed too tight or is pulling on the pelvic floor muscles or nerves. Usually, surgeons place the mesh tension-free to help minimize risk of this complication.
No matter how careful the surgeons are in placing the mesh, sometimes it may cause pain during the process of healing. Treatment of these complications involves a surgical procedure to remove the mesh that causes the pain.
4) Pain with sexual intercourse after Vaginal Mesh Surgery:
This complication happens if the mesh arms are placed too tight, or heal too tight, and are under tension causing a “pulling” on the muscle.
Pain with intercourse is a risk with any vaginal procedure, whether mesh is used or not. Upon examination, the area of pain can be located and the mesh tension causing the pain can be palpated as well.
Treatment may be either conservative treatment (if minor pain) with pelvic floor physical therapy, anti-inflammatory drug injections, or if more severe, corrective surgery may be necessary.
5) Fistula formation or Infection after Vaginal Mesh Surgery:
These are major complications, however fortunately are very rare. Symptoms include fever, infection, vaginal pus drainage, stool, or urine draining from the vagina. Mesh removal can involve major surgery.