Vaginal Mesh Exposure Following Pessary Use After Transvaginal Mesh Surgery: A Case Report

TL;DR

A case report shows that using a pessary after vaginal mesh surgery can lead to mesh exposure, which may cause serious complications if ignored.

Contribution

Highlights mesh exposure as a potential complication of pessary use following transvaginal mesh surgery.

Findings

Pessary use after mesh surgery led to vaginal mesh exposure in a patient after 3 years.

Mesh exposure can result in complications like infection and intra-abdominal abscess if not addressed.

The patient required mesh excision surgery and had a successful recovery.

Abstract

Vaginal pessaries are a widely used treatment for pelvic organ prolapse. They are considered minimally invasive, effective, and easy. However, pessary‐related adverse events are sometimes underestimated. Here, we report on an important case of vaginal mesh exposure as a pessary complication.

A patient underwent transvaginal mesh surgery for pelvic organ prolapse, and after 10 years, had a mild recurrence. Gynecologists recommended that she use a pessary. After 3 years, she had vaginal bleeding and malodor. Gynecologists detected mesh exposure, but they downplayed the finding and continued pessary use. Two years after that, she came to our hospital and underwent mesh excision surgery. She had an uneventful postoperative course with no complications in the 2 years after the surgery.

We propose that pessary use after mesh surgery can cause mesh exposure, which must not be ignored because it may lead to mesh infection and intra‐abdominal abscess.

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