Autologous graft for treatment of midurethral sling exposure without mesh excision.

Abstract

The midurethral sling is an effective treatment for stress urinary incontinence. Mesh exposure is a known complication of this procedure, with an associated rate of approximately 4%. Other than sling excision, there is minimal information on other options that may help to preserve an effective sling when an exposure has occurred. A patient presented with a mesh exposure 9 weeks after a retropubic midurethral sling. Conservative treatment with vaginal estrogen failed, as did primary reclosure in the operating room. She was then successfully treated with a full-thickness autologous vaginal epithelium graft. We report an alternative surgical option to mesh excision, which may help preserve an otherwise effective midurethral sling complicated by mesh exposure.