Pelvic floor disorders negatively affect quality of life of million sufferers, there has been a debate about the benefits and disadvantages of mesh usage in reducing POP and incontinence. In this report we share our experience in the management of mesh complications whom failed the first line of conservative management and we're referred to our centers.

282 cases from a total number of 305 refered patients between October of 2017 through November of 2024 have been included in our study. The cases were devided in four groups of A to D according to invasion to the bladder, urethra, vaginal or de-novo incomplete voiding.
Physical examination were done with surgical and medical history.
Based on patients chief complaints relevant surgical approaches were performed followed up planned  post up.

Data analysis revealed significant decrease in pai after reconstructive surgical interventions.
84.61% of patients in group A, 66.6% of group B, 67.9% of group C and 91.6% of group D were completely cured and unobstructed urinary flow were established, even more satisfying sexual satisfaction from their interactions were advised by the patients.
Even patients declared significant reduction in their supra-pubical, urethral and vagina pain compare to their high discomfort and ailment they were experiencing.
At first surgical attempt after thirty six month one individual subject from group B had complaints of urgent urinary incontinence and two other patients from group B and D were on clean intermittent catheterization.

Iatrogenic trauma to the bladder and urethra is the second most common mesh associated complication among 24% of patients.
In our study none of bladder presentation had been diagnosed intraoperatively during initial mesh sling surgery.
Another common complication has been unbalanced tensional mesh sling overlying mid-urethral about 12% failure to achieve urinary continence.
Other mesh specific problem is urethral erosion with incidence of 0.03% to 0.8% which may present may later exhibit as an vesico-vaginal and/or urethro-vaginal fistula.
Excision of extrudes mesh is helpful in relieving symptoms.
Although the persistence of pain after mesh removal has been reported in several studies, in this here study there was no report of significant pain after reconstructive surgery.

Intera-vesical mesh sling incision and/or partial removal successful in 98.43% of our patients.
37 underwent more than one session of reconstructive surgeries, the most complicated group were those with bladder neck and urethral involvement or loss.
The longest interval between the initial mesh sling procedure and mesh associated complications wee 20 years rasing concerns about the safety of the foreign materials and perhaps mandating physical examination at regular intervals for whom with history of intera-vaginal mesh surgery would be a solution.

Lin, L. et.al, comparison between tension free vaginal tape and trans obturator tape in treating stress urinary incontinence after vaginal mesh surgery. Taiwan journal obstrictive and gynecology. 2019.57
Shower, S., et.al. Total trans obturator tape removal, a case series including pain and urinary continence outcome. International uro-gynicology journal. 2022
Ulrich, D., et.al., Ten year follow up after tension free vaginal tape obturator procedure for stress urinary incontinence the journal of urology. 2016