Review the original procedure
Operation notes, implant details, imaging, and prior treatment records help establish what was placed and where.
Conditions & treatments
Complex pelvic floor care
Mesh Revision Surgery
Assessment and individualised management of complications following previous pelvic mesh or sling surgery.
Medical information: This is general information and does not replace professional medical advice.
Understanding the treatment
Clinical overview
Pelvic mesh and mid-urethral slings have been used in operations for pelvic organ prolapse and stress urinary incontinence. Some patients develop complications such as exposure, erosion, pain, infection, urinary symptoms, or difficulty emptying the bladder.
Revision does not always mean complete mesh removal. The appropriate approach depends on the type and location of the implant, the symptoms, previous operations, examination findings, and the patient’s priorities. In some situations, monitoring or non-surgical care may be more appropriate than another operation.
Interactive diagram
Mapping a mesh-related problem
Symptoms are assessed by the compartment where mesh was placed. Select a stage to see how assessment is structured.
Hover over or select a label to read a short description.
Three vaginal compartments
Pelvic surgery is described by compartment: anterior (bladder side), apical (top) and posterior (rectum side).
This is general information and does not replace professional medical advice.
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Theatre preparation
Prof Jeffery in scrubs during pre-operative preparation or scrubbing in. No patients, no identifiable staff without consent, no visible blood or tissue.
Before treatment
Assessment and shared decision-making
Treatment is planned only after the diagnosis, alternatives, expected benefits, limitations, and relevant risks have been discussed.
Define the current problem
A focused history and pelvic examination assess exposure, pain, urinary or bowel symptoms, and the effect on daily life.
Targeted investigations
Cystoscopy, ultrasound, urodynamics, or other imaging may be recommended when findings could change the treatment plan.
Shared treatment decision
Observation, local treatment, pain or pelvic-floor care, partial excision, complete removal, or reconstructive surgery are discussed as relevant.
Treatment pathway
What revision surgery may involve
The surgical route is tailored to the implant and the complication. Vaginal, laparoscopic, abdominal, or combined approaches may be considered.
01
Plan the extent of revision
The aim may be to release or divide a sling, remove exposed mesh, or remove a larger segment. Complete removal is not appropriate or technically possible in every case.
02
Protect adjacent structures
Mesh can lie close to the bladder, urethra, bowel, blood vessels, and nerves. Careful dissection and, where required, multidisciplinary input form part of planning.
03
Address associated problems
Prolapse, incontinence, or tissue defects may need treatment at the same operation or at a later stage, depending on the clinical circumstances.
04
Review recovery and symptoms
Follow-up assesses wound healing, bladder and bowel function, pain, and whether any staged care is needed.
Informed consent
Risks and limitations
All procedures carry risks. Individual risk varies with health, anatomy, previous surgery, and the planned treatment.
- Bleeding, infection, wound complications, and blood clots
- Injury to the bladder, urethra, ureters, bowel, blood vessels, or nerves
- Persistent or new pain, urinary symptoms, or pain during intercourse
- Recurrent or new prolapse or incontinence after mesh is removed or divided
- Fistula, scarring, incomplete removal, or the need for further surgery
- Symptoms may improve partly, remain unchanged, or occasionally worsen
Practical guidance
Recovery and follow-up
Hospital stay
Varies with the route and extent of surgery.
Early recovery
Pain control, bladder emptying, bowel function, and wound healing are monitored.
Activity
Restrictions are individualised; lifting, exercise, driving, and intercourse resume only when advised.
Follow-up
May include more than one review, particularly after complex or staged surgery.
Related information
Take the next step
Ready to discuss your options?
Prof Jeffery sees patients at three Cape Town locations. Booking is managed through the Urogynaecology Clinic (ULC).
Booking link takes you to urogynaecology.co.za — managed by the Urogynaecology Clinic team.