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#22914

The Use of Office-Based Vaginoscopy for Mesh Exposures at a Tertiary Care Center Patel R1, Christie A2, Zimmern P1 1. Department of Urology, U.T. Southwestern Medical Center, 2. Simmons Compr Cancer Center, U.T. Southwestern Medical Center KEYWORDS: New Instrumentation, Imaging, Pelvic Floor, Grafts: Synthetic A recent published joint statement by the American Urogynecologic Society (AUGS) and the International Urogynecological Association (IUGA) on the management of mesh-related complications in women who have been treated for pelvic organ prolapse (POP) or stress urinary incontinence (SUI) highlighted multiple gaps in evidence related to the evaluation and management of mesh exposure and mesh-related pain.[1] The detection of vaginal mesh exposure can be challenging due to intolerable pain, distorted anatomy such as a long and narrow vagina, or subtle findings that may go unnoticed. Imaging such as translabial ultrasonography (TLUS) and magnetic resonance imaging (MRI), while excellent for determining the type and course of the mesh material, or any associated complications, are not reliable modalities to detect mesh exposure.[2,3] Our group has used vaginoscopy – an office-based evaluation of the vaginal walls and apex with a flexible scope – as a simple and easily tolerated outpatient procedure to inspect the vagina in cases of suspected mesh/suture exposure without need for anesthesia. Because there is a paucity of data on the use of vaginoscopy in general, and none on its use in mesh-related complications, we present our experience with this technique along with corroborative findings at the time of mesh-related surgical repairs.