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Martius graft for management of exposed vaginal prolapse mesh.

Abstract
Although the use of vaginal mesh kits in treatment of pelvic organ prolapse (POP) has decreased the number of surgical failures, mesh exposure can occur. When conservative management fails, removing the exposed material is associated with the risk of recurrence of POP and could be challenging. We report a successful outcome of treatment of exposed mesh via use of a Martius bulbocavernosus fat pad. A 46-year-old woman had urinary incontinence and POP, which was treated using a vaginal mesh kit and tension-free vaginal tape. At 2 months after the procedure, the mesh was found to be exposed. After failed conservative management, use of a Martius graft was used, with preservation of the mesh. At 2-, 5-, and 10-month follow-up, the patient was completely asymptomatic and continent. This procedure may be a practical alternative in patients with synthetic mesh-induced vaginal erosion after failed conservative management.
AuthorsAhmed Al-Badr
JournalJournal of minimally invasive gynecology (J Minim Invasive Gynecol) 2013 Mar-Apr Vol. 20 Issue 2 Pg. 227-9 ISSN: 1553-4669 [Electronic] United States
PMID23295200 (Publication Type: Case Reports, Journal Article)
CopyrightCopyright © 2013 AAGL. Published by Elsevier Inc. All rights reserved.
Topics
  • Adipose Tissue (surgery)
  • Female
  • Humans
  • Middle Aged
  • Prosthesis Failure
  • Suburethral Slings (adverse effects)
  • Surgical Flaps
  • Surgical Mesh (adverse effects)
  • Uterine Prolapse (surgery)
  • Vulva (surgery)

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