All, N=75 (100%) Partial excision, n=48 (64%) Complete excision, n=27 (36%) P value 69 (92) 6 (8) 21 (28) 48 (64) 6 (8) 24 (35) 18 (27) 19 (28) 7 (10) 9 (12) 8 (14) 9 (12) 6 (8) 6 (0–50) 6 (8) 43 (90) 5 (10) 14 (29) 29 (60) 6 (13) 14 (32) 15 (34) 14 (32) 1 (2) 3 (6) 2 (5) 5 (11) 2 (4) 5 (0–50) 6 (13) 26 (96) 1 (4) 7 (26) 19 (70) 0 (0) 10 (42) 3 (13) 5 (21) 6 (25) 6 (23) 6 (29) 4 (15) 4 (15) 7 (1–42) 0 (0) Int Urogynecol J (2011) 22:1395–1404 Table 4 Outcomes of mesh excision Relief of mesh-related symptoms No improvement Improvement Complete relief Persistent exposure after mesh excision POP-Q stage after mesh excisiona POP-Q stage 0 POP-Q stage I POP-Q stage II POP-Q stage III Recurrence of POPb Recurrence of POP (POP mesh only, n=60)c De novo SUI after mesh excisiond De novo OAB after mesh excisione Follow-up (months) Need of re-excision Values are presented as median (range) or number (%). P value represents a comparison between the groups “partial excision” and “complete excision” a Missing, n=7; partial excision, n=4; complete excision, n=3 b Missing, n=2; partial excision, n=1; complete excision, n=1 c Missing, n=1; partial excision, n=1 d Missing, n=2; partial excision, n=1; complete excision, n=1 e Missing, n=2; partial excision, n=1; complete excision, n=1 had partial excision. Eventually, after this re-excision, five patients had complete relief and one had improvement of symptoms, none had exposure, none had recurrence of POP, one had de novo SUI, and one had de novo OAB. The group of patients who underwent excision of mesh used in sacrocolpopexy was not different from the other groups concerning the outcomes. All had relief of symp- toms (23% improvement and 77% complete relief of symptoms), none had exposure, three (25%) had recurrence of POP, one had SUI and one had OAB after mesh excision, and one patient needed re-excision of mesh. Discussion In this retrospective cohort study, we demonstrated that surgical mesh excision to treat complications after prior POP or SUI surgery with mesh was successful in the majority of cases, although with a substantial risk of serious complications and recurrence of POP or SUI. Only 8% of patients experienced no improvement of their symptoms. Main indications for mesh removal included pain (dyspar- eunia, vaginal pain, and/or pain in the lower abdomen, back, buttock, or leg), vaginal bleeding, and discharge, with or without evident mesh exposure. The frequency of these symptoms differed substantially between different types of mesh insertion procedure, but was similar to numbers found in other studies [14–17, 23, 24]. Pain and dyspareunia are mainly seen after vaginal mesh insertion and vaginal discharge and bleeding after sacrocolpopexy. Mesh exposures are often reported as painless [8, 9, 16]; however, pain is still found frequently together with exposures [14, 15, 17]. In our study, pain and mesh exposure were both frequently reported; however, patients with mesh exposure reported less pain symptoms than patients without exposure. Still, 54% of patients with mesh exposure did report pain symptoms (excluding dyspareunia, which is often already present before mesh insertion [8, 20]). The exposure itself may not have been the cause of pain. Underlying mesh contraction, although less severe contraction may not always be recognized at physical examination, could actually have induced the pain symp- toms [25]. It may also be possible that more complex cases of mesh exposures were seen at our tertiary referral center, in which pain may be more frequently present than in patients with less severe exposures. Most of the recent publications on vaginal mesh surgery report only short-term and medium-term follow-up results. Indeed, most of the mesh complications occur within the first postoperative year [9]. However, late complications 1401 0.410 0.410 0.764 0.389 0.082 0.417 0.054 0.335 0.006 0.061 0.019 0.712 0.178 0.557 0.082