081IC - Complications of Vaginal Mesh

Despite there being standards in the treatment of pelvic floor disorders, synthetic mesh implants are associated with unique complications which require expert evaluation and careful management. Although many surgeons are turning to alternative methods of reconstruction without mesh, the surgical treatment of mesh complications continues to increase. Complications from mesh placed for anti-incontinence procedures and transvaginal/abdominal pelvic organ prolapse repair include vaginal mesh extrusion; urethral, bladder, vascular or bowel perforation; pelvic pain and dyspareunia. The relative risks and presentation can vary depending on the approach and type of implant. Interactive, case-based discussion of these complications and their management, using photos and videos of surgery, will be the focus of the course. We will also review the management of patients with recurrent incontinence and/or prolapse after mesh excision for complications, involving the audience in an interactive discussion of very difficult cases in urology in addition to the different perspectives of 3 expert faculty from across the country. Finally, we discuss appropriate patient selection, counseling and surgical techniques for mesh implanters to reduce the risk of complication and litigation.