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Case Report
Surgical management of vaginal suburethral mesh erosion with ultra-thick amniotic membrane augmentation
1 Assistant Professor, Dept. Physician Assistant Studies, University of Kentucky Health Science, Lexington, KY, USA
2 Student, Dept. Physician Assistant Studies, University of Kentucky Health Science, Lexington, KY, USA
Address correspondence to:
Magdalene Karon
MD, 160 N Eagle Creek Dr # 205, Lexington, KY 40509,
USA
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Article ID: 100214Z08MK2025
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Karon M, Scheitzach C. Surgical management of vaginal suburethral mesh erosion with ultra-thick amniotic membrane augmentation. J Case Rep Images Obstet Gynecol 2025;11(2):28–31.ABSTRACT
Introduction: The transvaginal mesh sling is a primary consideration for urinary stress incontinence. However, the mesh is sharp and can erode through the vagina mucosa, making intercourse painful for both partners. Proximity to the urethra can also contribute to urethral and urinary infections which complicates the healing process of the open wound area. The exposed mesh necessitates resection with debridement of surrounding tissue. Primary closure may be difficult and cause fibrosis. Amniotic membrane is known to have anti-inflammatory and anti-scarring properties, which may facilitate closure and prevent post-surgical healing delays. Herein, we evaluate the adjunctive use of ultra-thick amniotic membrane (AM) to augment the surgical repair site for a complex mesh exposure.
Case Report: A 50-year-old Caucasian female (gravida 2, para 2) presented with vaginal mesh exposure (4 mm by 2 mm by 5 mm) from a transvaginal sling, placed approximately a year ago for stress urinary incontinence. The chief complaints were pain, bleeding, and dyspareunia. The patient underwent transvaginal excision of the exposed mesh and removal of neighboring scar and non-viable tissue. The vaginal defect with suture and adjunctive ultra-thick AM was incorporated into the closure. At one month post-op, the operative site was completely covered with vaginal mucosa and she did not have pain, bleeding, symptoms of prolapse or urinary incontinence. Six months later, the patient had no complaints.
Conclusion: This case report demonstrates the utilization and benefits of using ultra-thick AM augmentation in the setting of a vaginal mesh erosion complication.
Keywords: Amniotic membrane, Mesh complications, Mesh erosion, Surgical revision
SUPPORTING INFORMATION
Author Contributions
Magdalene Karon - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Cameron Scheitzach - Analysis of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2025 2025 Magdalene Karon.. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
