Mesh Complications

Mesh complications can occur after pelvic surgeries that used synthetic mesh for incontinence or prolapse. Although many patients never have problems, some may develop issues months or years later, such as mesh exposure, pelvic pain, urinary symptoms, bleeding, infection, or discomfort during intercourse.

These symptoms can be upsetting, but they are highly treatable with the right evaluation and surgical expertise. At The Medical Group of New Jersey, our urogynecology specialists provide detailed assessment and advanced surgical care to relieve symptoms, restore comfort, and help patients return to normal daily activities.

Symptom Onset & Initial Evaluation

Mesh complications may arise shortly after surgery or develop gradually over time. Symptoms vary based on mesh type, placement, and tissue response.

Common symptoms include:

• Vaginal spotting or bleeding
• Pain with intercourse (dyspareunia)
• Pelvic pain or pressure
• Recurrent urinary tract infections
• Painful urination or urinary urgency
• Mesh exposure or erosion visible in the vagina
• Vaginal discharge or odor
• Groin or leg pain (with retropubic or transobturator slings)

Symptoms may mimic other pelvic conditions, making expert evaluation essential.

Evaluation

The evaluation focuses on identifying the location, severity, and impact of the mesh complication. Your provider will also assess whether other pelvic floor conditions are contributing to symptoms.

During your visit at The Medical Group of New Jersey, your urogynecologist will:

• Review your surgical history, including type of mesh used
• Ask about when symptoms began and how they affect daily life
• Discuss urinary, bowel, and sexual function
• Evaluate the presence of vaginal dryness or tissue thinning
• Perform a gentle pelvic exam to identify mesh exposure, tenderness, or scar tissue
• Assess pelvic floor muscle tension or pain
• Determine whether diagnostic testing is needed to map mesh position

A compassionate, judgment-free environment is central to our evaluation approach, especially for patients who feel frustrated or discouraged by prior surgical experiences.

Diagnosis & Testing

Depending on symptoms, your provider may order additional tests to evaluate mesh placement, organ function, or associated conditions.

• Pelvic Examination: Identifies mesh exposure, pain points, infection, or scarring.
• Urinalysis & Urine Culture: Used to evaluate UTI symptoms or rule out infection.
• Post-Void Residual (PVR): Assesses bladder emptying when urinary symptoms are present.
• Cystoscopy: A small camera evaluates the bladder and urethra to determine if mesh has eroded internally.
• Pelvic Ultrasound or MRI: Helpful for mapping deeper mesh placement, scar tissue, or involvement of pelvic organs.
• Urodynamic Testing (selected cases): Evaluates bladder function if incontinence persists or reappears.

All necessary testing can be performed or coordinated through The Medical Group of New Jersey.

Treatment & Ongoing Management

Treatment depends on the type of complication, exposure, pain, erosion, or functional issues. Care is tailored to relieve symptoms while preserving pelvic support whenever possible.

Conservative Management (For Small Exposures or Mild Symptoms)

• Topical Vaginal Estrogen: Improves tissue healing and may help small mesh exposures re-epithelialize.
• Pelvic Floor Physical Therapy: Reduces muscle spasm or scar-related pain, especially when pain is muscular rather than mechanical.
• Antibiotics or Antifungals: Used only when infection is present.
• Activity Modifications: Avoiding intercourse or strenuous activity while tissues heal.

Surgical Management

Most moderate or severe mesh complications require surgical correction. Procedures vary based on mesh type and symptom severity.

• Partial Mesh Excision: Removes only the problematic portion of mesh—for example, the exposed or painful segment—while preserving support when appropriate.
• Complete Mesh Removal: Removal of mesh is necessary for mesh erosion into the bladder or urethra, severe pain or infection, or patients who prefer full removal.
• Vaginal Mesh Revision: Repairs or reinforces tissues after mesh removal.
• Sling Revision or Removal: For complications related to stress-incontinence slings, including groin or urethral pain, urinary obstruction, or recurrent UTIs.
• Advanced Reconstructive Surgery: Used when significant tissue repair is necessary after mesh removal.

At The Medical Group of New Jersey, surgical treatments are performed using minimally invasive and tissue-sparing techniques whenever possible.

Monitoring & Follow-Up

Follow-up care is essential for ensuring healing, preventing recurrence, and supporting sexual, urinary, and pelvic function.

Follow-up visits may include:

• Examination of the surgical site
• Review of bladder and bowel function
• Pain assessment and pelvic floor evaluation
• Adjustment of topical estrogen or other supportive therapies
• Review of physical therapy progress
• Monitoring for new or persistent symptoms

Patients who undergo mesh excision typically notice gradual improvement as tissues heal and inflammation resolves.