Int Urogynecol J (2011) 22:1395–1404 Partial excision, n=51 (63%) 11 (2–208) 1 (2) 34±26 52±107 Complete excision, n=30 (37%) 26 (5–217) 9 (30) 58±28 120±193 14 (27) 14 (27) 5 (10) 0 (0) 10 (20) 11 (21) 49 (96) 2 (4) 0 (0) 1 (2) 13 (25) 8 (16) 2 (4) 3 (6) 1 (2) 5 (10) 1±1 8 (27) 4 (13) 0 (0) 2 (7) 12 (40) 8 (27) 23 (77) 7 (23) 2 (7) 0 (0) 8 (27) 6 (20) 1 (3) 1 (3) 3 (10) 8 (27) 3±2 1400 Table 3 Characteristics of mesh excision surgery Time between mesh insertion and recent excision (months) Assistance of urologist Operation time (min) Blood loss (ml) Site of mesh excision Anterior vaginal wall Posterior vaginal wall Anterior and posterior vaginal wall Anterior and posterior vaginal wall and vaginal vault Vaginal vault Suburethral Approach Vaginala Abdominalb Use of hysteroscope Use of laparoscope Additional surgery POP SUI Other Intraoperative complications Postoperative complications Hospital stay (days) All, N=81 (100%) 16 (2–217) 10 (12) 43±29 77±147 22 (27) 18 (22) 5 (6) 2 (2) 22 (27) 19 (23) 72 (89) 9 (11) 2 (2) 1 (1) 21 (26) 14 (17) 3 (4) 4 (5) 4 (5) 13 (16) 2±2 Values are presented as mean±SD, median (range), or number (%). P value represents a comparison between the groups “partial excision” and “complete excision” a Two combined with hysteroscopy b Five combined with vaginal excision, one with laparoscope Postoperative complications occurred after 13 surgical procedures, including hematoma (n = 2), substantial bleed- ing (n = 1), ileus (n = 1), urinary tract infection (n = 5), urinary retention (n = 3), fever (n = 2), wound infection (n = 1), subcutaneous abscess (n = 1), fistula from cervix to sigmoid (n = 1), obstruction of a unilateral ureter and consequently blow-out of the kidney (n = 1). The latter serious complication occurred in a patient who appeared to have a bilateral relative ureteropelvic junction stenosis, which probably was aggravated by the surgery. She was treated by temporary insertion of a nephrostomy catheter. Complications seemed to be more frequent in the group with complete mesh excision, although this difference was not statistically significant. Complications were more common in the group with former sacrocolpopexy; intraoperative complications in this group occurred in 23% (vs 1%, P= 0.001) and, only during abdominal excision, postoperative complications in this group occurred in 46% (vs 12%, P= 0.003). All patients recovered completely after treatment of their complications. Outcomes are shown in Table 4. The majority of patients had relief, either complete relief or improvement, of mesh- related symptoms (92%). No difference was found between groups with regard to symptom relief, although five of six patients with no relief of symptoms had undergone a partial excision. Nine patients (12%) had recurrence of POP, of which eight were in the anterior compartment. The recurrence rate of POP was significantly higher in patients who underwent complete excision of mesh used in POP surgery (29%) compared to patients who underwent partial excision (5%). De novo SUI after mesh excision was more frequent in the group of patients who underwent excision of suburethral slings (36%) compared to patients who under- went excision of mesh used in POP surgery (7%, P= 0.010). Six patients (8%) needed re-excision of mesh; all had undergone a partial excision before. Four had persistent exposure of mesh in the vagina, one had a new exposure of mesh in the bladder, while she earlier had an exposure of mesh in the vagina, and one had persistent pain. Three patients underwent additional complete excision and three P value 0.001 <0.001 <0.001 0.066 0.939 0.140 0.152 0.134 0.046 0.601 0.011 0.011 0.134 1.000 0.907 0.762 1.000 0.609 0.141 0.062 <0.001