Synthetic mesh has become a popular treatment of pelvic floor relaxation and pelvic organ prolapse, with low complication rates. We describe the case of a woman with unilateral hydroureteronephrosis after a mesh procedure (Gynecare Prolift; Ethicon Women's Health & Urology, Ethicon, Inc., Somerville, New Jersey) successfully treated by neoureterocystostomy. A 39-year-old woman with pelvic organ prolapse underwent the mesh procedure. Two months later, she had left flank pain, and hydroureteronephrosis was diagnosed on the same side despite cystoscopic confirmation of ureteral passage at the first operation. The arm of the mesh was removed surgically, and neoureterocystostomy was performed successfully. Mesh surgery is not without serious complications, and surgeons should bear in mind the possible complications associated with this surgical procedure. Journal of Minimally Invasive Gynecology (2010) 17, 232-234 (c) 2010 AAGL. All rights reserved.