Genital prolapse or genital hernia is described as the protrusion of pelvic organs along the vagina. It is one of the common gynecological conditions that affect the quality of life in women. It may be seen in up to 50% of multipara women, and its incidence increases with age. High rates of recurrence with traditional techniques led to the development of new surgical techniques. The use of synthetic mesh has become more popular surgical approach in cystocele and rectocele repair.
Mesh migration is a well-known clinical pathology and have been reported in literature.4,5
The definitive mechanism for migration of a mesh has been discussed. Yolen and Grossman6
suggested that intra-abdominal foreign bodies (like mesh) transmigrate into the small or large bowel by triggering an inflammatory reaction. Persistent inflammatory reaction causes an opening into a hollow organ assisted by the peristaltic movement of the bowel. Insufficient fixation of a mesh is another factor for migration of synthetic materials in some patients. Another possible causative factor for mesh migration is selection of graft material. Macroporous, monofilament, soft polypropylene meshes are suggested. Larger pores greater than 75 nm permit the migration of macrophage and leukocyte migration and reduce the infection rate. Large pores also improves flexibility of the mesh and cause tissue ingrowths and healthy collagen deposition.7
Complications reported after sacropexy include ileus, intraoperative vessel injury, ureter injuries, recurrent descensus and mesh tearing.8
The use of a mesh as a graft material results in higher success rates but also causes a higher number of complications, such as mesh erosions or chronic infections.9
Sola was used polypropylene mesh in 31 patients with cystocele or rectocele. There were no long term complication with mesh such as vaginal or rectal protrusion.10
Bujons et al. reported vaginal protrusion of a prolene mesh after cystocele repair.11
reported a case of rectal migration of mesh in a 64-year-old woman who presented with a recto-cutaneous fistula 11 months after a tension-free vaginal (TVM) repair; the patient was treated by removal of the infected mesh and closure of the rectal wall defect under cover of a temporary colostomy. By contrast with the troublesome symptoms reported in such patients in the literature, the only presenting complaint of our patient was protrusion of foreign material from the rectum.