Female stress urinary incontinence and pelvic organ prolapse are prevalent conditions in adult women. Among treatment alternatives, more traditional methods of surgical intervention have been supplanted by synthetic polypropylene mesh kits. However, novel complications with mesh-related exposure, pelvic pain alone or with dyspareunia, and increased incidence of revision surgeries, resulted in 2 FDA warnings on transvaginal mesh use for prolapse repair. This review examines the anatomy of the vagina and urethra, the etiology of pain related to mesh use, and the relevant surgical techniques for management of this complication along with their outcomes.