American Urogynecologic Society

View all recommendations from this society

Released June 24, 2020

Do not perform surgery for asymptomatic vaginal exposure of monofilament mesh.

Vaginal exposure of mesh used in surgery for the treatment of pelvic organ prolapse or urinary incontinence is a known complication of such surgeries. Although symptomatic exposure may require treatment, evidence suggests that asymptomatic mesh exposure can be safely watched without surgery to avoid the risks and complications associated with surgery for mesh exposure. Longitudinal expectant management is a reasonable alternative.

These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.

How The List Was Created

The Clinical Practice Committee of the American Urogynecologic Society (AUGS) reviewed clinical evidence to identify possible topics along with suggestions for possible topics from the AUGS Board of Directors. By consensus, the Clinical Practice Committee selected the top five most overused tests within specified parameters. Additional input was sought from the AUGS Board of Directors and incorporated. The final list was reviewed and approved by the AUGS Board of Directors.

AUGS’ listing of board and committee members and conflict of interest policy can be found at


American College of Obstetrics & Gynecology Committee Opinion No. 694: Management of Mesh and Graft Complications in Gynecologic Surgery. Obstetrics & Gynecology.2017 Apr;129(4):e102-8.

Deffieux X, Thubert T, de Tayrac R, Fernandez H, Letouzey V. Long-term follow-up of persistent vaginal polypropylene mesh exposure for transvaginally placed mesh procedures. International Urogynecology Journal 2012 Oct; 23:1387-90.

Kobashi KC, Govier FC. Management of vaginal erosion of polypropylene mesh slings. Journal of Urology. 2003 Nov;169: 2242-3.