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This case report describes a patient who underwent transvaginal mesh surgery for pelvic organ prolapse, later developed mild recurrence, and used a pessary for three years before experiencing vaginal bleeding and malodor. Mesh exposure was identified, initially downplayed, and excision surgery was performed, leading to an uncomplicated recovery and no recurrence over two years.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/vaginal-mesh-exposure-following-pessary-use-after-transvaginal-mesh-surgery-a-case-report/455122/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/vaginal-mesh-exposure-following-pessary-use-after-transvaginal-mesh-surgery-a-case-report/455122.png","ImageObject",300,407,{"name":92,"@type":93},"Alexandar","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",13,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What treatment is discussed for pelvic organ prolapse, and why is it relevant?","Question",{"text":113,"@type":114},"The report discusses vaginal pessaries as a practical option for pelvic organ prolapse, highlighting that pessary-related adverse events can be underestimated. It focuses specifically on a case where pessary use was linked to vaginal mesh exposure.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How did the patient develop vaginal mesh exposure after surgery and pessary use?",{"text":118,"@type":114},"After transvaginal mesh surgery, the patient experienced mild recurrence and used a pessary for three years. She then developed vaginal bleeding and malodor, and examination confirmed an 8 by 10 mm mesh exposure in the anterior vaginal wall.",{"name":120,"@type":111,"acceptedAnswer":121},"What was the outcome after partial mesh excision surgery?",{"text":122,"@type":114},"The patient underwent partial mesh excision under spinal anesthesia. The postoperative course was uneventful, with no bleeding, discharge, malodor, or recurrence of mesh exposure during two years of follow-up.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},455122,1791035143,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":19,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":52,"preview_page_count":4},962090768658,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","IJU Case Reports  \n CASE REPORT  OPEN ACCESS   \nVaginal Mesh Exposure Following Pessary Use After Transvaginal Mesh Surgery: A Case Report  \nYukiko Tsunoda1  | Kumiko Kato2 | Hidemori Araki3 | Masashi Kato4 | Masahiro Narushima2  \n1Department of Female Urology, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, Japan | 2Department of Female Urology, Meitetsu Hospital, Nagoya, Japan | 3Department of Urology, Meitetsu Hospital, Nagoya, Japan | 4Department of Urology, Japanese Red Cross Aichi  \nMedical Center Nagoya Daiichi Hospital, Nagoya, Japan Correspondence: Yukiko Tsunoda ([yuki.t.t1106@gmail.com](yuki.t.t1106@gmail.com))  \nReceived: 22 July 2025 | Revised: 23 November 2025 | Accepted: 18 December 2025  \nKeywords: mesh complication | mesh exposure | pelvic organ prolapse | pessary complication | transvaginal mesh surgery (TVM)  \nABSTRACT  \nIntroduction: Vaginal pessaries are a widely used treatment for pelvic organ prolapse. They are considered minimally invasive, effective, and easy. However, pessary-related adverse events are sometimes underestimated. Here, we report on an important case of vaginal mesh exposure as a pessary complication.  \nCase Presentation: A patient underwent transvaginal mesh surgery for pelvic organ prolapse, and after 10years, had a mild recurrence. Gynecologists recommended that she use a pessary. After 3 years, she had vaginal bleeding and malodor. Gynecologists detected mesh exposure, but they downplayed the finding and continued pessary use. Two years after that, she came to our hospital and underwent mesh excision surgery. She had an uneventful postoperative course with no complications in the 2 years after the surgery.  \nConclusion: We propose that pessary use after mesh surgery can cause mesh exposure, which must not be ignored because it may lead to mesh infection and intra-abdominal abscess.  \n1 | Introduction  \nVaginal pessaries are considered a noninvasive, practical treatment for pelvic organ prolapse (POP) [1] . However, they are associated with complications including vaginal infections and erosions (pressure ulcers) leading to bleeding, discharge, and malodor [1] . Although rare, more serious complications must not be forgotten. These include vaginal impaction, vesicovaginal and rectovaginal fistula, and vaginal vault perforation with bowel evisceration [2, 3] .  \nVaginal mesh exposure is a well-known complication after POP surgeries using mesh such as transvaginal mesh surgery (TVM) and laparoscopic sacrocolpopexy (LSC) . In contrast, complications caused by pessary use after POP have been overlooked  \nby researchers. Therefore, we present a case of vaginal mesh exposure following 3 years of pessary use, 13 years after TVM surgery.  \n2 | Case Presentation  \nAt the age of 53, the patient underwent anterior TVM surgery to treat POP in the Department of Gynecology at a general hospital. Polypropylene mesh (Gynemesh) was attached between the urinary bladder and the anterior vaginal wall. At age 63, she experienced a descending sensation in her vagina and detected an egg-sized mass with her fingers while bathing. She revisited the general hospital, but the operating surgeon had retired, and the attending physician had limited experience in urogynecology. She  \n\n| Abbreviations: LSC, laparoscopic sacrocolpopexy; POP, pelvic organ prolapse; TVM, transvaginal mesh prolapse surgery. |\n| --- |\n| This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.\u003Cbr>© 2026 The Author(s). IJU Case Reports published by John Wiley & Sons Australia, Ltd on behalf of Japanese Urological Association. |\n\nIJU Case Reports, 2026; 9:e70135 1 of 4  \n[https://doi.org/10.1002/iju5.70135](https://doi.org/10.1002/iju5.70135)  \nKeynote Message  \nVaginal pessaries are a simple and effective treatment for POP. However, serious complications such as vesicovagi","cbCaifpyierDQfgF","https://ap.wps.com/l/cbCaifpyierDQfgF","pdf",587074,"English","# Introduction\n# Case Presentation\n# Discussion","[{\"question\":\"What treatment is discussed for pelvic organ prolapse, and why is it relevant?\",\"answer\":\"The report discusses vaginal pessaries as a practical option for pelvic organ prolapse, highlighting that pessary-related adverse events can be underestimated. It focuses specifically on a case where pessary use was linked to vaginal mesh exposure.\"},{\"question\":\"How did the patient develop vaginal mesh exposure after surgery and pessary use?\",\"answer\":\"After transvaginal mesh surgery, the patient experienced mild recurrence and used a pessary for three years. She then developed vaginal bleeding and malodor, and examination confirmed an 8 by 10 mm mesh exposure in the anterior vaginal wall.\"},{\"question\":\"What was the outcome after partial mesh excision surgery?\",\"answer\":\"The patient underwent partial mesh excision under spinal anesthesia. The postoperative course was uneventful, with no bleeding, discharge, malodor, or recurrence of mesh exposure during two years of follow-up.\"}]","Vaginal Mesh Exposure Following Pessary Use After Transvaginal Mesh Surgery - A Case Report | PDF",1790742169]