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Transvaginal synthetic mesh: Management of exposure and pain following pelvic surgery

John B Gebhart, MD, MS
Emanuel C Trabuco, MD, MS
Section Editor
Linda Brubaker, MD, FACOG
Deputy Editor
Kristen Eckler, MD, FACOG


Vaginal synthetic mesh is inserted to augment native tissue; however, these materials have been associated with numerous complications including mesh exposure, perforation, or contraction; pelvic pain; dyspareunia; infection; urinary and bowel dysfunction; and fistula formation [1-5]. This topic will discuss the diagnosis and management of exposure (erosion) and pain resulting from vaginal mesh insertion. Other types of mesh complications are reviewed separately.


Clinical findings and diagnosis — Patients may present with mesh exposure, vaginal bleeding, pelvic pain, dyspareunia, and partner irritation during sex [5,6]. Women with persistent vaginal bleeding, abnormal vaginal discharge, or recurrent urinary tract infections after mesh placement should be evaluated for possible mesh exposure [7]. Alternately, some patients feel the mesh themselves. Rare patients with mesh exposure are asymptomatic. The prevalence of symptom type varies by indication for surgery (incontinence versus prolapse), anatomic location of mesh (suburethral, anterior, apical, or posterior), and mode of insertion (transvaginal mesh versus mesh kits). The most common symptoms have a wide prevalence range, but are consistently present in at least 10 percent of patients and include [1,6,8-13]:

Pelvic or vaginal pain

Mesh exposure


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Literature review current through: Nov 2017. | This topic last updated: Nov 13, 2017.
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