Laparoscopic apical mesh excision for deep dyspareunia caused by mesh banding in the vaginal apex

Archives of Gynecology and Obstetrics
M Sami Walid, Richard L Heaton

Abstract

Gynecare Prolift has been successfully used for pelvic floor repair with favorable objective and subjective outcomes. There have been, however, increasing reports of significant rates of postoperative dyspareunia and impairment of sexual function. We are presenting two cases of post Prolift dyspareunia. The patients underwent several vaginal revisions with excision of the apical bands. However, they returned soon with the same complaint. Ultimately, laparoscopic excision of the apical mesh was performed. Patients reported significant improvement in their intercourse pain after the procedure. Our experience shows that new onset dyspareunia is primarily caused by the apical component of the Prolift system with deep penetration pain reproduced by pressure on the fixed nondistensible apex. This problem can be treated laparoscopically with excision of the apical mesh.

References

Jun 28, 2000·American Journal of Obstetrics and Gynecology·A M WeberM R Piedmonte
Aug 22, 2008·International Urogynecology Journal and Pelvic Floor Dysfunction·Kari NieminenPentti K Heinonen
Oct 11, 2008·American Journal of Obstetrics and Gynecology·Beri RidgewayJ Eric Jelovsek
Oct 22, 2008·Taiwanese Journal of Obstetrics & Gynecology·Shih-Shien Weng, Chung-Yuan Liu
Nov 4, 2008·American Journal of Obstetrics and Gynecology·Joye K LowmanDouglass S Hale
Nov 5, 2008·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Annett Gauruder-BurmesterRalf Tunn

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Citations

Jun 10, 2010·Current Opinion in Urology

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