Archives of Gynecology and Obstetrics

, Volume 280, Issue 3, pp 347–350 | Cite as

Laparoscopic apical mesh excision for deep dyspareunia caused by mesh banding in the vaginal apex

  • M. Sami Walid
  • Richard L. Heaton
Original Article



Gynecare Prolift has been successfully used for pelvic floor repair with favorable objective and subjective outcomes. There have been, however, increasing reports of significant rates of postoperative dyspareunia and impairment of sexual function.

Materials and methods

We are presenting two cases of post Prolift dyspareunia. The patients underwent several vaginal revisions with excision of the apical bands. However, they returned soon with the same complaint. Ultimately, laparoscopic excision of the apical mesh was performed.


Patients reported significant improvement in their intercourse pain after the procedure.


Our experience shows that new onset dyspareunia is primarily caused by the apical component of the Prolift system with deep penetration pain reproduced by pressure on the fixed nondistensible apex. This problem can be treated laparoscopically with excision of the apical mesh.


Prolift Dyspareunia Laparoscopy Vaginal apex Apical banding 


Conflict of interest statement

None of the authors has any potential conflict of interest.


  1. 1.
    Weng SS, Liu CY (2008) Laparoscopic pelvic floor repair using polypropylene mesh. Taiwan J Obstet Gynecol 47(3):312–317. doi: 10.1016/S1028-4559(08)60130-8 PubMedCrossRefGoogle Scholar
  2. 2.
    Ridgeway B, Walters MD, R Paraiso MF, Barber MD, McAchran SE, Goldman HB, Jelovsek JE (2008) Early experience with mesh excision for adverse outcomes after transvaginal mesh placement using prolapse kits. Am J Obstet Gynecol, 7 October [Epub ahead of print]Google Scholar
  3. 3.
    Lowman JK, Jones LA, Woodman PJ, Hale DS (2008) Does the Prolift system cause dyspareunia? Am J Obstet Gynecol, 31 October [Epub ahead of print]Google Scholar
  4. 4.
    Hinoul P, Ombelet WU, Burger MP, Roovers JP (2008) A prospective study to evaluate the anatomic and functional outcome of a transobturator mesh kit (prolift anterior) for symptomatic cystocele repair. J Minim Invasive Gynecol 15(5):615–620. doi: 10.1016/j.jmig.2008.05.009 PubMedCrossRefGoogle Scholar
  5. 5.
    Weber AM, Walters MD, Piedmonte MR (2000) Sexual function and vaginal anatomy in women before and after surgery for pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol 182(6):1610–1615. doi: 10.1067/mob.2000.107436 PubMedCrossRefGoogle Scholar
  6. 6.
    Gauruder-Burmester A, Koutouzidou P, Tunn R (2008) Effect of vaginal polypropylene mesh implants on sexual function. Eur J Obstet Gynecol Reprod Biol, 1 November [Epub ahead of print]Google Scholar
  7. 7.
    Nieminen K, Hiltunen R, Heiskanen E, Takala T, Niemi K, Merikari M, Heinonen PK (2008) Symptom resolution and sexual function after anterior vaginal wall repair with or without polypropylene mesh. Int Urogynecol J Pelvic Floor Dysfunct 19(12):1611–1616. doi: 10.1007/s00192-008-0707-7 PubMedCrossRefGoogle Scholar
  8. 8.
    Sarlos D, Brandner S, Kots L, Gygax N, Schaer G (2008) Laparoscopic sacrocolpopexy for uterine and post-hysterectomy prolapse: anatomical results, quality of life and perioperative outcome-a prospective study with 101 cases. Int Urogynecol J Pelvic Floor Dysfunct 19(10):1415–1422. doi: 10.1007/s00192-008-0657-0 PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  1. 1.Medical Center of Central GeorgiaMaconUSA
  2. 2.Heart of Georgia Women’s CenterWarner RobinsUSA

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