Native tissue repair after failed synthetic materials

Abstract

In the setting of an emerging patient population suffering from recurrent pelvic floor symptoms after mesh removal, the principles and practices of native tissue repair have taken on a new, ever-important position in vaginal reconstructive surgery. This chapter provides a case-study of a patient who undergoes complex mesh removal, with improvement in her constellation of presenting symptoms. Although she improves significantly, she goes on to develop recurrent prolapse in the setting of persistent stress urinary incontinence (SUI). Description of her management details techniques for surgical intervention that we have used successfully after mesh removal to treat deficient, attenuated, atrophied, and scarred pelvic floor tissues.