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Women's Health
Mesh Complications
Expert assessment and surgical management for women experiencing complications following mesh surgery for incontinence or prolapse.
Clinically Reviewed By
Honorary Associate Professor Jeremy Ockrim
Consultant Urological Surgeon · Reviewed May 2026 · Review due May 2027
Understanding Mesh Complications
Synthetic mesh has been widely used in gynaecological and urological surgery since the late 1990s, primarily to treat stress urinary incontinence and pelvic organ prolapse. Procedures such as tension-free vaginal tape (TVT), transobturator tape (TOT), and mesh-augmented prolapse repairs were once considered routine and were performed on hundreds of thousands of women across the UK and worldwide.
While the majority of women have benefited from mesh surgery without any problems, a significant number have experienced serious and life-changing complications. These can develop immediately, weeks, months, or even years after the original procedure. In response to growing concerns, NHS England introduced a pause on the routine use of surgical mesh for stress urinary incontinence and prolapse in 2018. This pause remains in effect — mesh procedures for SUI may only be performed under highly restricted conditions at specialist centres, and vaginal mesh for prolapse repair is no longer recommended for routine use. The Independent Medicines and Medical Devices Safety Review (the Cumberlege Review), published in 2020 as First Do No Harm, highlighted the devastating and often life-changing impact mesh complications have had on affected women.
If you are experiencing problems following mesh surgery, it is important to know that you are not alone and that specialist help is available. Mesh complications require assessment and management by a surgeon with specific expertise in this area. Honorary Associate Professor Ockrim is one of the four mesh surgeons working at the London Complex Mesh Centre (LCMC) at University College London Hospital and has extensive experience in evaluating mesh-related problems and performing complex mesh removal surgery, and we are committed to providing compassionate, expert care at every stage.
You deserve specialist support
Mesh complications are a recognised and serious issue. If you are in pain, experiencing recurrent infections, or noticing new symptoms after previous mesh surgery, a specialist assessment can help identify the cause and determine the best course of action. You do not need to suffer in silence.
Types of Mesh Complications
Mesh complications can vary significantly in nature and severity. Some women experience a single problem, while others develop multiple overlapping symptoms. The following are the most commonly encountered complications:
Chronic Pain
Persistent pelvic pain, groin pain, or leg pain that may develop gradually or suddenly after mesh placement. Pain can be constant or triggered by movement, sitting, or physical activity, and may significantly affect quality of life.
Mesh Erosion – Extrusion / Exposure
The mesh can erode through the vaginal wall, urethra, or bladder, or more rarely the ureter or into the bowel. This may cause visible or palpable mesh, discharge, bleeding, and pain during intercourse. Erosion into the urinary tract can lead to recurrent infections and stone formation on the mesh.
Infection
Mesh can harbour bacteria and lead to chronic or recurrent infections that do not respond fully to antibiotics. Infected mesh often requires surgical removal to achieve lasting resolution.
Urinary Symptoms
New or worsening urinary symptoms including recurrent UTIs, frequency-urgency symptoms, difficulty emptying the bladder (voiding dysfunction), and paradoxically, new or recurrent (worsening) urinary incontinence.
Sexual Dysfunction
Pain during intercourse (dyspareunia) is one of the most common mesh-related complaints. Partners may also feel or be scratched by exposed mesh. This can have a profound impact on relationships and emotional wellbeing.
Scar Contraction / Shrinkage
Over time, scar tissue can form around the mesh causing it to contract and shrink. This can lead to tightening of the vaginal wall, restricted movement, and worsening pain that becomes progressively more debilitating.
Symptoms to Be Aware Of
If you have previously had mesh surgery for incontinence or prolapse, you should seek specialist assessment if you are experiencing any of the following symptoms. These may develop at any time after the original procedure — even many years later.
Pain during intercourse (dyspareunia) — persistent or new-onset pain that was not present before mesh surgery, or pain felt by your partner during intimacy.
Visible or palpable mesh — you or your partner can feel or see mesh material protruding through the vaginal wall.
Recurrent infections — repeated urinary tract infections or vaginal infections that do not fully clear with antibiotics, potentially indicating mesh erosion or colonisation.
New or worsening urinary symptoms — difficulty passing urine, urgency, frequency, or new urinary leakage that developed after your mesh procedure.
Unusual discharge or bleeding — vaginal discharge that is persistent, discoloured, or foul-smelling, or unexpected vaginal bleeding.
Chronic pelvic, groin, or leg pain — pain that may radiate to the groin, inner thigh, or buttock, often worsened by sitting, walking, or physical activity.
How We Assess Mesh Complications
A thorough and methodical assessment is essential to understand the extent of mesh-related problems and to plan the most appropriate treatment. Our assessment typically includes:
Specialist Clinical Examination
A detailed history and careful clinical examination to assess the position and condition of the mesh, identify any erosion, and evaluate pelvic floor function. This is carried out sensitively and with full explanation at every step.
Cystoscopy
A flexible or rigid cystoscopy allows us to look directly inside the bladder and urethra to check whether mesh has eroded into the urinary tract. This is a quick, well-tolerated procedure which is performed under local or general (daycase) anaesthetic.
Imaging (MRI / Ultrasound)
Specialist MRI and/or pelvic ultrasound may be used to visualise the position and extent of the mesh, identify collections or abscesses, and plan surgical removal. These non-invasive investigations provide valuable information about the surrounding tissues.
Urodynamics
Urodynamic studies assess bladder function in detail — measuring how the bladder fills, stores, and empties urine. This is particularly important if you are experiencing voiding difficulties or incontinence, and helps guide surgical planning.
Multidisciplinary Review
Complex cases benefit from input across multiple specialities. We work closely with colleagues in gynaecology, colorectal surgery, pain management, and physiotherapy to ensure every aspect of your care is considered and that you receive the most appropriate treatment plan.
Treatment Options
The right treatment depends on the type and severity of your mesh complication, your symptoms, and your overall health. We take a personalised approach and discuss all available options with you in detail before recommending a plan.
Conservative Management
Non-SurgicalFor women with mild symptoms or those who are not yet ready for surgery, conservative approaches may provide meaningful relief:
- ›Specialist physiotherapy — pelvic floor rehabilitation to address muscle dysfunction and pain
- ›Pain management — medication, nerve blocks, or referral to a chronic pain specialist
- ›Topical oestrogen — to improve vaginal tissue health and support healing, particularly in post-menopausal women
Partial Mesh Removal
Specialist SurgeryWhere mesh has eroded through the vaginal wall or into the urinary tract, partial removal of the exposed or problematic portion may be appropriate. This can often resolve localised symptoms such as discharge, bleeding, or pain during intercourse, while avoiding the complexity of complete removal. The decision between partial and complete removal is a joint decision between surgeon and patient, and made on an individual basis.
Many patients have staged surgery with the initial surgery focussed on removing the mesh component causing the acute symptoms. A staged (second) procedure is then required to deal with the consequences — most commonly incontinence. At the second surgery the remaining mesh components can be removed.
Complete Mesh Removal
Specialist SurgeryComplete mesh removal is a complex surgical procedure often involving surgical access via the vagina, abdomen and groins (as appropriate). It may be recommended when mesh has caused widespread pain, chronic infection, significant erosion, or when partial removal has not resolved symptoms. The surgery involves carefully dissecting the mesh from surrounding tissues — including the bladder, urethra, and vaginal wall, gynaecological organs or bowel as required — while preserving function as much as possible.
Honorary Associate Professor Ockrim has extensive experience in mesh complication management and removal. His expertise in complex reconstructive urology means patients can be confident they are in the hands of a surgeon who understands the intricacies of mesh surgery and the importance of a tailored, individual approach to your specific needs.
Reconstruction After Mesh Removal
Reconstructive SurgeryFollowing mesh removal, some women require a second staged procedure to manage the consequences of mesh removal, most commonly recurrent incontinence and/or prolapse. There are multiple options for vaginal and abdominal reconstructive surgery to repair the vaginal wall, urethra, or bladder. These may include tissue grafting or additional continence procedures. Some of the options available are described in the Urinary Incontinence and Pelvic Organ Prolapse pages. Reconstruction is planned carefully and discussed fully with you, taking into account your symptoms, functional priorities, and recovery expectations.
Support & Next Steps
Dealing with mesh complications can be an isolating and distressing experience. We understand the emotional toll this takes, and we are here to support you at every stage — from initial assessment through to treatment and long-term follow-up.
Patient Advocacy
There are a number of patient advocacy groups online including organisations such as Sling the Mesh and the MHRA Yellow Card scheme that can provide information, support networks, and a means to report your experience. All patients in the UK with mesh complications should be treated by accredited mesh specialist surgeons or units. NHS England has established specialist mesh centres across England for assessment and removal. Honorary Associate Professor Ockrim is one of the four mesh surgeons working at the London Complex Mesh Centre (LCMC) at University College London Hospital NHS Trust — your GP can refer you to Honorary Associate Professor Ockrim or any of the other centres. We are also available for patients seeking private specialist care.
Reporting Complications
We can help you report your mesh complications through the appropriate regulatory channels, contributing to the ongoing evidence base and supporting other affected women.
Ongoing Care
We provide long-term follow-up after mesh removal, including ongoing monitoring, physiotherapy and specialist referrals including pain, psychology, colorectal and urogynaecology services, and additional treatment if needed to optimise your recovery.
Meet your Specialist
Assessment and treatment of mesh complications is led by our specialist reconstructive urologist Honorary Associate Professor Jeremy Ockrim. Your care will be personally overseen by him from initial consultation through to long-term follow-up.
Key Takeaways
Mesh complications are real and recognised
Thousands of women have been affected. If you are experiencing symptoms following mesh surgery, your concerns are valid and deserve specialist assessment.
Effective treatments are available
A thorough evaluation by an experienced surgeon and multidisciplinary team is the first step towards understanding your symptoms and identifying the most appropriate treatment. Depending on your individual circumstances, options may range from conservative management to complete mesh removal and reconstructive surgery.
Living with mesh complications can be exhausting—physically, emotionally and mentally. Many women tell us they have felt dismissed, disbelieved or unsure where to turn. We take your concerns seriously and are committed to providing clear answers, honest guidance and expert care throughout your treatment.
Whether you are seeking a first opinion, a second opinion or wish to discuss your treatment options, we are here to help. With specialist assessment and appropriate treatment, many women experience significant relief from their symptoms, improved function and a better quality of life.
Further Reading
Frequently Asked Questions
Transvaginal mesh is a synthetic (usually polypropylene) implant used to support the vaginal wall or urethra in the surgical treatment of pelvic organ prolapse and stress urinary incontinence. It became controversial because a small proportion of women developed serious complications including chronic pain, mesh erosion into the vagina, bladder or bowel, dyspareunia, recurrent infections and voiding difficulties. In the UK, the use of mid-urethral mesh slings has been paused since 2020 pending high-vigilance restrictions, and transvaginal mesh for prolapse has been largely abandoned.
Common symptoms include chronic pelvic, vaginal, groin or thigh pain, pain during intercourse (dyspareunia), pain reported by a partner, unusual vaginal discharge or bleeding, recurrent urinary tract infections, difficulty passing urine or incomplete emptying, and in some cases the ability to feel or see exposed mesh. Symptoms may develop weeks, months or years after the original operation.
Diagnosis involves a detailed clinical history and symptom review, careful pelvic and vaginal examination often under anaesthetic, cystoscopy and vaginoscopy to look for mesh exposure or erosion, and specialised imaging such as pelvic MRI or transvaginal ultrasound to map the exact position of the mesh. Urodynamic studies may also be needed if there are voiding or continence symptoms.
Yes. Partial or complete mesh removal is possible but is a specialist procedure that should only be performed by surgeons with specific training and experience in mesh complications. Complete removal is not always advisable or achievable — the mesh becomes embedded in surrounding tissue and complete excision can carry a risk of injury to the bladder, urethra, bowel and blood vessels. Decisions about the extent of removal are individualised and shared between patient and surgeon.
Many women experience significant improvement in pain and other mesh-related symptoms after removal, but this is not guaranteed and outcomes vary. Symptoms driven directly by mesh (such as exposure, erosion or infection) tend to respond best. Chronic neuropathic pain that has developed over months or years can persist even after complete removal. Realistic goals and multi-disciplinary support — including pain specialists, physiotherapy and psychological support — are important throughout the process.
Non-mesh surgical options are available for both stress urinary incontinence and pelvic organ prolapse. For stress incontinence these include colposuspension (Burch procedure), autologous fascial sling, urethral bulking (Bulkamid) and artificial urinary sphincter. For prolapse, options include native-tissue vaginal repair, sacrocolpopexy-sacrohysteropexy using the patient’s own tissue, and vaginal pessaries as a non-surgical option. Honorary Associate Professor Jeremy Ockrim at London Urology Specialists was among the first UK surgeons to pioneer non-mesh approaches.
Women with suspected mesh complications should be referred to a specialist mesh centre for assessment. Under the NHS, mesh complications are managed through designated regional mesh centres. In the private sector, you can self-refer or ask your GP or existing consultant to refer you. Honorary Associate Professor Jeremy Ockrim is one of the specialist mesh surgeons at the London Complex Mesh Centre at University College London Hospital and has extensive experience in the assessment and management of mesh-related complications and will provide a full multidisciplinary assessment.
Experiencing Mesh Complications?
Book a consultation with one of our specialist consultants for expert assessment and advice on the treatment options available to you.