Name of the Condition

• Erosion of implanted vaginal mesh to surrounding organ or tissue, subsequent encounter

Summary

Erosion of implanted vaginal mesh occurs when the mesh device, used to manage pelvic organ prolapse or stress urinary incontinence, begins to wear through surrounding tissues or organs. This can lead to discomfort and other symptoms necessitating further medical evaluation and intervention.

Causes

The condition can result from several factors, including improper surgical technique, infection, inflammation, or the body's rejection or reaction to the mesh material. Over time, wear and tear or physical stress on the implanted mesh may also contribute to erosion.

Risk Factors

• Prior pelvic surgeries
• Infections
• Chronic inflammation
• Physical activity that places stress on the pelvic area
• Smoking or compromised healing due to other medical conditions

Symptoms

• Chronic pelvic pain
• Vaginal discharge or bleeding
• Pain during intercourse
• Urinary problems, such as incontinence or urgency
• Sensation of mesh exposure or erosion

Diagnosis

• Physical examination to check for signs of erosion
• Imaging tests like ultrasound or MRI, if needed, to assess the erosion extent
• Cystoscopy or other diagnostic procedures for detailed assessment

Treatment Options

• Non-surgical management, such as topical estrogen therapy, to improve tissue health
• Surgical intervention to remove or repair the eroded mesh and restore normal function
• Antibiotics if infection is present

Prognosis and Follow-Up

• Prognosis varies based on the extent of erosion and success of treatment
• Regular follow-ups are crucial to monitor healing and detect any recurrence or complications early

Complications

• Persistent pain
• Infection
• Damage to nearby organs or tissues
• Recurrence of pelvic organ prolapse or incontinence

Lifestyle & Prevention

• Avoid placing undue strain on the pelvic region post-surgery
• Follow a healthy lifestyle to improve overall healing, including proper diet and smoking cessation
• Regular medical check-ups to monitor for early signs of erosion

When to Seek Professional Help

• Persistent or worsening pelvic pain
• Noticeable changes in urinary or sexual function
• Unusual vaginal discharge or bleeding

Additional Resources

• American Urogynecologic Society (www.augs.org)
• Pelvic Floor Disorders Network (pfdnetwork.org)

Tips for Medical Coders

• Ensure "subsequent encounter" is accurately reflected in the coding to indicate continuing care.
• Verify that documentation supports the specific encounter type and extent of erosion.
• Avoid coding errors by distinguishing this condition from initial encounters or revisions without erosion.