1402 may arise after a long period of time. We found mesh- related complications even up to 18 years after mesh insertion and, in 36% of mesh excisions, the time between mesh insertion and removal was more than 2 years, mostly after sacrocolpopexy. Marcus-Braun et al. found mesh- related complications up to 8 years after mesh placement; in 56%, the delay from the primary operation was more than 2 years [13]. Time between mesh insertion and excision was longer in the group of patients who underwent complete mesh excision, probably because they have undergone more minor interventions (former partial mesh excision) to treat their complications in this period. Not every mesh-related complication requires complete excision, although complete excision of mesh is sometimes advocated to avoid multiple procedures and to achieve optimal relief of symptoms [14, 24, 26]. In our study, most patients (64%) underwent partial excision of mesh. Never- theless, we found no difference in relief of symptoms between partial and complete excision. Ridgeway et al. described 19 cases of mesh removal in which the degree of mesh excision was tailored to the severity of the compli- cations. This resulted also in great alleviation of symptoms in most cases [16]. In our series, patients with more serious complaints indeed underwent more often a complete mesh excision. A substantial number of patients (36%) required multiple procedures, of which most had been performed in other centers before referral to our hospital. This corresponds with numbers of women requiring multiple procedures found by others ranging from 20% to 38% [13, 15, 26]. This number may be overestimated in a tertiary referral center, as the more straightforward cases of mesh exposure that are recovered with a single (office) excision will not be referred. Recurrence of POP after excision of mesh used in POP surgery was more common with complete excision than with partial excision (29% vs 5%) and affected the anterior vaginal wall in 7 of 47 (15%) cases of mesh excision from the anterior vaginal wall or vaginal vault. Nevertheless, consistent with a previous study, the majority of patients (86%) did not have recurrence of POP after mesh excision [13]. Possibly, the formation of scar tissue and fibrosis after mesh insertion surgery provides sufficient support to prevent the recurrence of POP in most patients who had mesh excision, even though in complete mesh excision the interlaced fibrotic tissue may be removed. De novo SUI after mesh excision occurred in 13% of all patients and reoccurred in 36% after excision of a suburethral sling, which is consistent with recurrence rates of SUI up to 47% after suburethral sling excisions in other studies [13, 27]. The small amount of scar tissue around the suburethral tape is often not enough to remain supportive after mesh excision. Int Urogynecol J (2011) 22:1395–1404 In two of our patients (who underwent surgery without the assistance of a urologist), very serious urologic complications occurred. Bilateral ureter lesion occurred in one of the first complete excisions of vaginal mesh performed at our center. This incident has led to a policy in which the urologist is being involved with the more extensive and complex surgeries. Also, the urologist is always involved in the treatment of patients with (suspected) mesh complications affecting the bladder. Furthermore, intraoperative and postoperative complica- tions (5% and 16%, respectively) were found relatively frequent in our study compared to the study of Marcus- Braun et al. [13]. In their retrospective study of 104 cases of surgical vaginal mesh removal, intraoperative complications occurred only twice (2%) and postoperative complications in 10 operations (10%). However, they did not evaluate patients with mesh excision after sacrocolpopexy. Most complica- tions in our patients occurred in the group of patients who underwent abdominal excision of mesh used in sacrocolpo- pexy. This is consistent with the findings of South et al. who described that abdominal excision of eroded vaginal mesh after prior abdominal sacrocolpopexy involves more serious complications compared to the vaginal route [26]. The impact of this study is limited by its retrospective design and descriptive nature. It is, therefore, susceptible to recall and interpretation bias. Moreover, since data were collected retrospectively, 32% of the patients had a follow- up of only 2 months. Therefore, the postoperative follow-up may have been too short to find recurrences of POP in some cases. Furthermore, 17% of patients underwent concomitant POP or SUI surgery, which may have reduced the rate of recurrence of POP and de novo SUI we found. Incidence figures are hard to reproduce in this heteroge- neous population, in which patients were often referred by various other hospitals. We were able to estimate the incidence of mesh-related complications only for Prolift™ inserted at our center. Of the patients included in this study, 20 underwent insertion of Prolift™ at our hospital between halfway of 2005 and end of 2009. In this period, 180 Prolift™ meshes were inserted. So, 20 out of 180 (11%) patients with Prolift™ inserted at our center developed complications that required excision. All 20 patients initially underwent partial excision, of which 2 required a re-excision (1 partial and 1 complete). As these patients originated from our center, the excisions included both minor and major complications. It can be concluded that, after the insertion of Prolift™, 0.6% needs excision for severe mesh-related complications and 11% for minor complications. This incidence number is consistent with numbers found in other studies [9, 13, 21]. Prolift™ was the most removed mesh material in our patients (40%). This could be explained by the fact that, in this region, Prolift™ is the most used mesh material in