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Mesh Complications & Removal — POP and SUI Mesh

Mesh complications in urogynecology represent a major clinical and regulatory concern, encompassing a spectrum of adverse events following synthetic-mesh use for pelvic organ prolapse (POP) repair and stress urinary incontinence (SUI) surgery (midurethral slings). This page is the canonical reference for diagnosis, classification, management, and removal techniques across both indications.

For the indication-and-augmentation framework see Mesh & Graft-Augmented Prolapse Repair. For the broader prolapse-repair atlas see Prolapse Repair (04g). For the female-SUI sling decision-framework see Female SUI Database.

Regulatory Background and Current Status​

The FDA issued its first public-health notification in 2008 after receiving over 1,000 adverse-event reports, followed by a 2011 safety communication identifying serious safety concerns.[1] In 2016, transvaginal mesh for POP was reclassified as a Class III (high-risk) device, and by April 2019, the FDA ordered all remaining transvaginal mesh products for POP off the US market — manufacturers had failed to demonstrate an acceptable long-term benefit-risk profile vs native-tissue repair.[2][3]

Carve-outs from the 2019 FDA POP-mesh ban

The April 2019 FDA order applies to transvaginal mesh products for POP only. It does NOT apply to:

  • Midurethral slings for SUI (gold-standard procedure with substantially lower complication profile).[2][4]
  • Transabdominal mesh for sacrocolpopexy (Class II).[2]

Similar bans or restrictions on transvaginal POP mesh have been enacted in the UK, Australia, New Zealand, Scotland, and Canada.[1]

IUGA / ICS Classification System​

The IUGA / ICS 2011 joint terminology provides a standardized framework for synthetic-mesh complications using a Category–Time–Site (CTS) code.[5]

AxisCodes
Category (C)C1 vaginal-epithelial separation / exposure; C2 urinary-tract involvement; C3 rectal / bowel involvement; C4 skin / musculoskeletal; C5–C7 patient compromise (pain, infection, abscess)
Time (T)T1 intraoperative; T2 early postoperative (≤ 48 h); T3 ≤ 2 months; T4 > 2 months
Site (S)S1 vaginal suture line; S2 away from suture line; S3 trocar passage; S4 other

In the Miklos 2016 multicenter validation series of 445 patients with mesh complications, pain was the most common presenting symptom (spontaneous pain 32.5%, dyspareunia 14.7%), and the majority presented > 1 year after implantation (mean 3.68 years).[6]

Complication Rates by Procedure Type​

ComplicationTransvaginal mesh (POP)Midurethral sling (SUI)Sacrocolpopexy
Mesh erosion / exposure4–12%1–2%3.5–10%
Chronic pain6.7%0.6%Variable
Dyspareunia4.8–13% (mesh kits)~ 19% of sexually activeVariable
De novo SUI~ 15.5%N/AN/A
Reoperation for mesh complications6–8%~ 1.1% at 5 yr2–19%
Bladder injury~ 1.8%VariableRare

The MacCraith 2021 systematic review of nearly 293,000 patients confirmed that mesh erosion is significantly higher after POP surgery (4%) than SUI surgery (1.9%) (OR 2.13), and chronic pain rates are dramatically higher in the POP group (6.7% vs 0.6%; OR 11.02). Both complications typically manifest within the first year after surgery (mean ~ 307 and ~ 326 days).[7]

Specific Complications​

Mesh exposure / erosion​

The most well-characterized complication. For transvaginal POP mesh, the Yeung 2024 Cochrane review reported an exposure rate of 11.8%, with 6.1% requiring surgical intervention.[1] For sacrocolpopexy, the CARE trial found a 7-year mesh-complication rate of 10.5%.[2] The Bretschneider 2024 5-year follow-up of laparoscopic / robotic total hysterectomy + sacrocolpopexy confirmed gradually increasing exposure risk over time.[8]

Risk factors.

  • Larger vaginal incision size (> 2.5 cm).
  • Sexual activity.
  • Higher BMI.
  • Concurrent total hysterectomy (for sacrocolpopexy).[9][10]
  • Lightweight polypropylene mesh is associated with fewer graft-related complications than heavier-weight mesh — 7.3% vs 22.8% in the Page 2023 long-term Obstet Gynecol analysis.[11]

Pain and dyspareunia​

Pain is now the most common reason for mesh removal, surpassing erosion.[1] Risk factors for de novo pelvic pain include younger age, fibromyalgia, early postoperative pain, poorer physical health, and somatization.[12] In the PROSPECT trial secondary analysis (Reid 2021), de novo severe dyspareunia occurred in 1.4–4.8% across repair types, with mesh kits showing the highest rate (4.8%).[13]

Voiding dysfunction (midurethral slings)​

Short-term voiding dysfunction after midurethral sling placement is common — approximately 20% on postoperative day 1, declining to 6% at 2 weeks and 2% at 6 weeks.[14] Most cases are self-limited. Long-term bladder-outlet obstruction can lead to high-pressure voiding, ureteral reflux, upper-tract dilation, and detrusor decompensation, requiring sling release.[14]

Organ perforation​

Bladder perforation occurs in approximately 1.8% of transvaginal mesh POP repairs.[1] Rectal perforation, ureteral injury, and vesicovaginal fistula are rare but reported and should be excluded with cystoscopy / proctoscopy / imaging when symptoms suggest visceral involvement.[15]

Management — ACOG / AUGS Committee Opinion 694 Framework​

The ACOG Committee Opinion No. 694 provides the primary management guidance.[14]

ScenarioManagement
Asymptomatic mesh exposure (type 1 monofilament macroporous)Expectant management. No intervention needed for asymptomatic patients.[2][14]
Small symptomatic exposures (< 0.5 cm)Vaginal estrogen; observation; or office-based trimming if persistent.
Persistent or larger exposuresSurgical excision of exposed mesh edges with tension-free vaginal reclosure. If this fails — autologous graft transposition or Martius flap.[14]
Pelvic pain / dyspareunia related to non-exposed meshComplex — may not respond to mesh removal. Refer to an FPMRS specialist.[14]
Voiding dysfunction after slingShort-term — observe up to 6 weeks with CIC. Long-term obstruction (≥ 3 months) — urodynamic evaluation + sling release.[14]
Mesh-removal surgeryShould NOT be performed without a specific therapeutic indication.[14]

Multiple-interventions reality​

  • Abbott 2014 multicenter study — 60% of women with mesh complications required ≥ 2 interventions; 49% required surgical intervention as initial treatment; among those initially managed nonsurgically, 59.3% ultimately required surgery.[16]
  • Kowalik 2021 SR/meta — mesh-revision surgery alleviates symptoms in approximately 75% of women, though 29% need subsequent operations.[17]

Diagnostic workup​

Tailored to clinical scenario — may include cystoscopy, proctoscopy, colonoscopy, or radiologic imaging.[14]

Sentinel Symptoms Warranting Evaluation​

Persistent vaginal bleeding, vaginal discharge, recurrent UTIs, pelvic pain, or dyspareunia after mesh placement should prompt examination and further evaluation for mesh exposure or erosion.[14]

Imaging Evaluation​

The ACR Appropriateness Criteria for pelvic-floor dysfunction emphasize that no single imaging modality is universally best — the optimal choice depends on the specific anatomic region being evaluated and the clinical question. Pelvic-floor ultrasound and MRI have complementary roles.[31]

Pelvic-floor ultrasound (translabial / transperineal / transvaginal)​

Preferred first-line modality for the sub- and periurethral portions of midurethral slings and vaginal mesh. Synthetic polypropylene appears highly echogenic on ultrasound — making ultrasound the only modality some experts consider capable of reliably visualizing mesh, given that mesh is often difficult to distinguish from scar tissue on MRI.[32][33]

Strengths.

  • Inexpensive, readily available, quick, easy to learn; can be performed in the office or intraoperatively with a standard curvilinear transducer.[34]
  • Differentiates retropubic from transobturator slings by sling-arm position; demonstrates sling disruption, folding, urethral impingement, and erosion not apparent on physical exam or cystoscopy.[34]
  • Real-time dynamic assessment during Valsalva.
  • Transvaginal ultrasound (TVUS) detects implanted mesh / sling material that physical examination misses in ~ 28% of cases.[31]
  • 3D endovaginal ultrasound (EVUS) provides tomographic reconstructions confirming the presence / absence of vaginal-wall mesh, identifying residual mesh after excision, and assessing mesh relationship to the urethral lumen — crucial for surgical planning.[32]

Diagnostic performance for mesh complications.

IndicationModalitySensitivitySpecificityNPVNotes
Lower-urinary-tract mesh exposure (n = 100)Combined translabial + transvaginal pelvic-floor US100%98–100%100%Excellent screening test to rule out bladder / urethral mesh exposure[35]
Sling erosion into urethra / bladder (n = 124)Translabial ultrasound (incl. intramural mesh)93%72%—Outperforms cystourethroscopy alone (sensitivity 67%) for early or intramural erosion[36]

Limitations.

  • Cannot visualize retropubic components of urethral slings.
  • Cannot visualize extrapelvic components traversing the obturator foramen or ischiorectal fossa.
  • Cranial / apical sacrocolpopexy mesh is poorly seen.[31]

For ultrasound-page detail on PFUS technique and reference ranges, see Ultrasound — Pelvic Floor (Transperineal / Translabial).

MRI pelvis with gadolinium​

Preferred examination for the majority of subacute or chronic complications after pelvic-floor surgery, especially for global pelvic-floor anatomy and components ultrasound cannot reach.[31][37]

Indications where MRI is preferred.

  • Retropubic sling components (better than ultrasound).
  • Obturator and ischiorectal sling components.
  • Sacrocolpopexy mesh integrity, presacral hematomas.
  • Mesh infection, abscess, discitis / osteomyelitis.
  • Peripheral nerve assessment via MR neurography.
  • Global pelvic-floor anatomy for surgical planning.

For MRI-page detail see MRI — Pelvis.

Complementary roles — ultrasound vs MRI​

FeatureUltrasound (TUS / TVUS / TPUS)MRI pelvis
Periurethral / suburethral slingSuperiorLimited
Retropubic sling armsLimitedSuperior
Obturator / ischiorectal componentsCannot visualizeSuperior
Sacrocolpopexy meshLimited (apical / cranial)Superior
Dynamic assessment (Valsalva)Superior (real-time)Possible but limited
Mesh vs scar differentiationBetter (echogenicity)Difficult
Global pelvic-floor anatomyLimitedSuperior
Cost / accessibilityLow cost, office-basedHigher cost, less accessible
Intraoperative useYesNo

Imaging-evaluation bottom line​

Translabial / transperineal ultrasound is the best first-line imaging modality for evaluating mesh in the vaginal and periurethral regions due to high sensitivity, real-time dynamic capability, low cost, and office-based accessibility.[32][33][34][35] MRI is superior for retropubic / obturator / sacrocolpopexy mesh components and for assessing global pelvic-floor anatomy, infection, abscess, or nerve involvement.[31][37]

These scans should be performed and interpreted by pelvic-floor specialists with core competency in pelvic-floor ultrasound — incidental findings are common and clinical correlation is essential.[32]

Complete vs Partial Mesh Removal​

The central clinical question — whether complete or partial mesh removal yields superior outcomes — remains incompletely resolved, with no randomized controlled trials to guide decision-making.[18] Existing evidence is entirely retrospective.

POP mesh complications​

Bergersen 2021 Urology (n = 78 patients undergoing mesh removal for pain / dyspareunia).[19]

  • Symptoms resolved or improved in 85.9% overall.
  • No significant difference between complete (46.7% resolved, 40.0% improved) and partial removal (51.5% resolved, 33.3% improved; p = 0.82).
  • Complete removal associated with numerically higher recurrent symptomatic POP (31.1% vs 15.2%, p = 0.12 — not statistically significant).
  • ~ 30% required additional reconstructive procedures.

Midurethral sling complications​

Doyle 2022 Obstet Gynecol SR/meta-analysis of 45 studies.[20]

  • Partial sling removal had significantly lower rates of postoperative SUI vs total removal (OR 0.46, 95% CI 0.22–0.96).
  • Postoperative SUI — 19.2% partial vs 48.7% total.
  • Both approaches were similar for pain resolution, bladder-outlet obstruction, mesh exposure, and lower-urinary-tract symptoms.

Palmieri 2024 — separate cohort of 204 patients undergoing complete continence-mesh removal — 80.5% reported recurrent SUI on urodynamic follow-up.[21]

Outcomes by indication for removal​

The indication for removal is a critical predictor of surgical success.

IndicationImprovement rateKey finding
Mesh exposure only73.9–95%Most reliably treated; nearly always resolved surgically
Exposure + pain58.3%Intermediate outcomes
Pain alone33.3%Poorest outcomes; PFDI / PFIQ scores did not improve despite VAS pain reduction

Pace 2021 BJOG prospective longitudinal study of 173 women undergoing complete vaginal mesh excision demonstrated this pattern (p = 0.03 across groups). VAS pain scores decreased across all groups, but validated quality-of-life measures (PFDI, PFIQ) did not improve in the pain-only group.[22]

Souders 2022 14-year single-center experience (n = 113) confirmed pain resolution in 50% and dyspareunia resolution in 52%, but 21% had persistent pain and 4% developed de novo pain.[23] Crosby 2014 Obstet Gynecol cohort confirmed similar symptom-resolution patterns after operative management of transvaginal mesh complications.[24]

Surgical Approaches​

Transvaginal excision​

The most commonly used approach — employed in approximately 84.5% of mesh-removal cases.[23] ACOG recommends starting with vaginal excision of visualized mesh, reserving abdominal or laparoscopic approaches for cases where vaginal excision fails.[14]

Stepwise approach for sacrocolpopexy mesh erosion[25]​

  1. Initial transvaginal excision of exposed mesh — success rate ~ 53%; may require up to 3 attempts.
  2. If vaginal excision fails — abdominal (open or laparoscopic) excision achieves 100% symptom resolution in small series, but carries higher morbidity (bowel injury requiring resection, wound complications, longer recovery).
  3. Laparoscopic sacrocolpopexy mesh excision is feasible and can be combined with repeat prolapse repair when indicated; Mohr 2023 Int Urogynecol J step-by-step technique description.[26]

Robot-assisted mesh removal​

Fong 2022 J Endourol prospective series of 30 patients — complete or near-complete mesh removal in 83.3%, median operative time 240 minutes. Concomitant reconstructive procedures in 40% of patients. Three Clavien-Dindo grade 3b complications (ureteric / bladder injury, omental bleed, groin wound infection).[27]

Concomitant Reconstructive Surgery​

Recurrent prolapse and SUI are common sequelae of mesh removal, making concomitant or staged reconstruction an important consideration.

  • After POP-mesh removal — 30.3% required additional reconstructive procedures.[19]
  • After midurethral-sling removal — recurrent SUI in approximately 40–49% of women, with 14% undergoing repeat surgery. Minimally invasive interventions (bulking agents, neuromodulation, onabotulinumtoxinA) after sling removal achieve success rates of 75–86% depending on incontinence type.[14][28]
  • Concomitant reconstructive procedures during mesh removal performed in up to 40% of robot-assisted cases.[27]

Counseling Considerations​

Per ACOG Committee Opinion 694.[14]

  • Mesh removal should NOT be performed without a specific therapeutic indication — asymptomatic patients do not benefit.
  • Counsel about the complex trade-offs between positive and adverse pelvic-floor functions with each additional procedure.
  • Pain may not resolve after mesh removal, particularly when pain is the sole indication. Refer to an FPMRS specialist experienced in mesh removal.
  • Multiple procedures are often required — 60% of women with mesh complications need ≥ 2 interventions; 29% require subsequent operations after initial mesh revision.[16][17]
  • The overall evidence base remains limited in quality — entirely retrospective with heterogeneous outcome measures and variable follow-up.[18]
  • Mesh-removal surgery should be performed by experienced pelvic surgeons at high-volume centers — lower-volume surgeons have higher complication rates.[29]

Current Clinical Implications​

  • Transvaginal POP mesh has limited utility in primary surgery given the risk-benefit profile, though it may still be considered in selected high-risk patients (e.g., recurrent anterior / apical prolapse, comorbidities precluding longer procedures) under appropriate oversight.[1][2]
  • Midurethral slings remain the gold standard for SUI with a substantially lower complication profile, though their availability has been affected by the broader mesh controversy in some countries.[4][30]
  • Sacrocolpopexy with type 1 mesh remains a standard approach for apical prolapse, with surgical success rates exceeding 95% at 5 years, though mesh-exposure risk gradually increases over time.[8]

See Also​

References​

1. Yeung E, Baessler K, Christmann-Schmid C, et al. Transvaginal mesh or grafts or native-tissue repair for vaginal prolapse. Cochrane Database Syst Rev. 2024;3:CD012079. doi:10.1002/14651858.CD012079.pub2

2. American College of Obstetricians and Gynecologists' Committee on Practice Bulletins—Gynecology and American Urogynecologic Society. Pelvic organ prolapse: ACOG Practice Bulletin Number 214. Obstet Gynecol. 2019;134(5):e126–e142. doi:10.1097/AOG.0000000000003519

3. AUGS / SGS. Pelvic organ prolapse. Female Pelvic Med Reconstr Surg. 2019;25(6):397–408. doi:10.1097/SPV.0000000000000794

4. Wu JM. Stress incontinence in women. N Engl J Med. 2021;384(25):2428–2436. doi:10.1056/NEJMcp1914037

5. Haylen BT, Freeman RM, Swift SE, et al. An International Urogynecological Association (IUGA) / International Continence Society (ICS) joint terminology and classification of the complications related directly to the insertion of prostheses (meshes, implants, tapes) and grafts in female pelvic floor surgery. Int Urogynecol J. 2011;22(1):3–15. doi:10.1007/s00192-010-1324-9

6. Miklos JR, Chinthakanan O, Moore RD, et al. The IUGA / ICS classification of synthetic mesh complications in female pelvic floor reconstructive surgery: a multicenter study. Int Urogynecol J. 2016;27(6):933–938. doi:10.1007/s00192-015-2913-4

7. MacCraith E, Cunnane EM, Joyce M, et al. Comparison of synthetic mesh erosion and chronic pain rates after surgery for pelvic organ prolapse and stress urinary incontinence: a systematic review. Int Urogynecol J. 2021;32(3):573–580. doi:10.1007/s00192-020-04612-x

8. Bretschneider CE, Myers ER, Geller EJ, et al. Long-term mesh exposure 5 years following minimally invasive total hysterectomy and sacrocolpopexy. Int Urogynecol J. 2024;35(4):901–907. doi:10.1007/s00192-024-05769-5

9. Çetin Arslan H, Arslan K. Risk factors and outcomes of vaginal mesh erosions after pelvic reconstructive surgery: a retrospective cohort study. Medicine (Baltimore). 2025;104(19):e42442. doi:10.1097/MD.0000000000042442

10. Deblaere S, Hauspy J, Hansen K. Mesh exposure following minimally invasive sacrocolpopexy: a narrative review. Int Urogynecol J. 2022;33(10):2713–2725. doi:10.1007/s00192-021-04998-2

11. Page AS, Cattani L, Pacquée S, et al. Long-term data on graft-related complications after sacrocolpopexy with lightweight compared with heavier-weight mesh. Obstet Gynecol. 2023;141(1):189–198. doi:10.1097/AOG.0000000000005021

12. Geller EJ, Babb E, Nackley AG, Zolnoun D. Incidence and risk factors for pelvic pain after mesh implant surgery for the treatment of pelvic floor disorders. J Minim Invasive Gynecol. 2017;24(1):67–73. doi:10.1016/j.jmig.2016.10.001

13. Reid FM, Elders A, Breeman S, Freeman RM. How common are complications following polypropylene mesh, biological xenograft and native tissue surgery for pelvic organ prolapse? A secondary analysis from the PROSPECT trial. BJOG. 2021;128(13):2180–2189. doi:10.1111/1471-0528.16897

14. American College of Obstetricians and Gynecologists' Committee on Gynecologic Practice. Committee Opinion No. 694: management of mesh and graft complications in gynecologic surgery. Obstet Gynecol. 2017;129(4):e102–e108. doi:10.1097/AOG.0000000000002022

15. Firoozi F, Ingber MS, Moore CK, et al. Purely transvaginal / perineal management of complications from commercial prolapse kits using a new prostheses / grafts complication classification system. J Urol. 2012;187(5):1674–1679. doi:10.1016/j.juro.2011.12.066

16. Abbott S, Unger CA, Evans JM, et al. Evaluation and management of complications from synthetic mesh after pelvic reconstructive surgery: a multicenter study. Am J Obstet Gynecol. 2014;210(2):163.e1–8. doi:10.1016/j.ajog.2013.10.012

17. Kowalik CR, Lakeman MME, Zwolsman SE, Roovers JWR. Efficacy of surgical revision of mesh complications in prolapse and urinary incontinence surgery. Int Urogynecol J. 2021;32(8):2257–2264. doi:10.1007/s00192-020-04543-7

18. Carter P, Fou L, Whiter F, et al. Management of mesh complications following surgery for stress urinary incontinence or pelvic organ prolapse: a systematic review. BJOG. 2020;127(1):28–35. doi:10.1111/1471-0528.15958

19. Bergersen A, Price E, Callegari M, et al. Pain resolution and recurrent prolapse rates following vaginal mesh removal. Urology. 2021;150:134–138. doi:10.1016/j.urology.2020.06.057

20. Doyle PJ, Grimes CL, Balk EM, et al. Surgical removal of midurethral sling in women undergoing surgery for presumed mesh-related complications: a systematic review. Obstet Gynecol. 2022;139(2):277–286. doi:10.1097/AOG.0000000000004646

21. Palmieri S, Kuria E, Gonzales G, Sarfoh R, Elneil S. Postoperative outcomes and urodynamic findings after continence mesh removal. Int J Gynaecol Obstet. 2024;164(1):334–338. doi:10.1002/ijgo.15051

22. Pace N, Artsen A, Baranski L, et al. Symptomatic improvement after mesh removal: a prospective longitudinal study of women with urogynaecological mesh complications. BJOG. 2021;128(12):2034–2043. doi:10.1111/1471-0528.16778

23. Souders CP, Miranda AF, Sahor F, et al. Long-term outcomes and complications of trans-vaginal mesh removal: a 14-year experience. Urology. 2022;169:70–75. doi:10.1016/j.urology.2022.07.039

24. Crosby EC, Abernethy M, Berger MB, et al. Symptom resolution after operative management of complications from transvaginal mesh. Obstet Gynecol. 2014;123(1):134–139. doi:10.1097/AOG.0000000000000042

25. South MM, Foster RT, Webster GD, Weidner AC, Amundsen CL. Surgical excision of eroded mesh after prior abdominal sacrocolpopexy. Am J Obstet Gynecol. 2007;197(6):615.e1–5. doi:10.1016/j.ajog.2007.08.012

26. Mohr S, Imboden S, Mueller MD, Kuhn A. Laparoscopic sacrocolpopexy mesh excision step-by-step. Int Urogynecol J. 2023;34(8):1987–1989. doi:10.1007/s00192-023-05494-5

27. Fong E, Yao HH, Zargar H, Connell HE. Early experience of transabdominal and novel transvaginal robot-assisted laparoscopic removal of transvaginal mesh. J Endourol. 2022;36(4):477–492. doi:10.1089/end.2021.0520

28. Singla N, Aggarwal H, Foster J, et al. Management of urinary incontinence following suburethral sling removal. J Urol. 2017;198(3):644–649. doi:10.1016/j.juro.2017.02.3341

29. Rogo-Gupta L, Castellanos M. When and how to excise vaginal mesh. Curr Opin Obstet Gynecol. 2016;28(4):311–315. doi:10.1097/GCO.0000000000000292

30. Carter E, Johnson EE, Still M, et al. Single-incision sling operations for urinary incontinence in women. Cochrane Database Syst Rev. 2023;10:CD008709. doi:10.1002/14651858.CD008709.pub4

31. Khatri G, Bhosale PR, Robbins JB, et al. ACR Appropriateness Criteria® pelvic floor dysfunction in females. J Am Coll Radiol. 2022;19(5S):S137–S155. doi:10.1016/j.jacr.2022.02.016

32. Taithongchai A, Sultan AH, Wieczorek PA, Thakar R. Clinical application of 2D and 3D pelvic-floor ultrasound of mid-urethral slings and vaginal-wall mesh. Int Urogynecol J. 2019;30(9):1401–1411. doi:10.1007/s00192-019-03973-2

33. Shek KL, Dietz HP. Ultrasound imaging of slings and meshes in urogynecology. Ultrasound Obstet Gynecol. 2021;57(4):526–538. doi:10.1002/uog.23545

34. Kim KY, Cheng JW, Shen JK, Wagner H, Staack A. Translabial ultrasound evaluation of pelvic-floor structures and mesh in the urology office and intraoperative setting. Urology. 2018;120:267. doi:10.1016/j.urology.2018.07.004

35. Frigerio M, Barba M, Marino G, Volonte S, Cola A. Pelvic-floor ultrasound evaluation in the diagnosis of exposure of synthetic implanted materials in the lower urinary tract. Int J Gynaecol Obstet. 2023;163(3):834–839. doi:10.1002/ijgo.14933

36. Viragh KA, Cohen SA, Shen L, et al. Translabial US: preoperative detection of midurethral sling erosion in stress urinary incontinence. Radiology. 2018;289(3):721–727. doi:10.1148/radiol.2018180786

37. Ram R, Jambhekar K, Glanc P, et al. Meshy business: MRI and ultrasound evaluation of pelvic floor mesh and slings. Abdom Radiol (NY). 2021;46(4):1414–1442. doi:10.1007/s00261-020-02404-x