Editing Functional: Mesh Complications (section)

== Management of Mesh Complications ==

* Expectant Management and Counseling
** Mild complications such as voiding dysfunction or discomfort often resolve spontaneously with minimal intervention, and careful monitoring of these patients is recommended.
*** A patient with asymptomatic mesh exposure without pain or pelvic organ dysfunction is an example of an appropriate candidate for expectant management.
* When complications persist past the perioperative period or do not resolve with conservative management, they may require medication or intervention. Such complications include:
*# Prolonged voiding dysfunction
*# Urinary obstruction
*# Vaginal pain or dyspareunia
*# Erosion into an organ or exposure through the vaginal wall
*# Defecatory dysfunction
** Medical Management
*** If an infectious component of mesh exposure is suspected, treatment with antibiotics is reasonable
*** If tissue atrophy is suspected, initiating vaginal estrogen can combat this process
** '''Surgical'''
*** '''Removal of mesh in cases of severe refractory pain may improve symptoms in most patients'''
*** Risk of anterior prolapse recurrence after mesh removal is 20%.
*** Risk of incontinence after sling removal ranges from 30% to 50%.
*** Patients with persistent urinary retention may be offered surgical urethrolysis