A Case of Recurrent Pelvic Organ Prolapse Treated with Robot-assisted Sacrocolpopexy after Infected Transvaginal Mesh Removal

Transvaginal mesh surgery (TVM) for pelvic organ prolapse (POP) has been widely performed, but is associated with mesh-related complications, such as vaginal wall erosion, infection, and abscess formation. We report a case of POP recurrence with mesh infection following posterior TVM surgery (TVM-P), where a favorable outcome was achieved through a two-stage treatment strategy. The patient was a 74-year-old woman with two prior deliveries. Following TVM-P, anterior wall POP recurrence along with infection and abscess formation at the right mesh arm were observed. Conservative treatment was ineffective, and the infected mesh was removed to control the infection. Although no recurrence of the abscess was detected, POP worsened to POP-Q stage 4. Therefore, single-mesh, anterior-wall-only robot-assisted sacrocolpopexy (RSC) was performed. No signs of infection or POP recurrence were noted 6 months postoperatively. While the use of a new mesh is generally contraindicated in cases of mesh infection, this case suggests that staged RSC after successful infection control may be a viable treatment option for recurrent POP. Shinshu Med J 74 : 279―284, 2026