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Mesh Complications and Vaginal Surgery: Part 1

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In all realms of medicine, advancement in patient care is a learning process, with the ultimate goal being better patient care. New technologies abound, and scientists and physicians are often at the cutting edge to adapt these technologies to patients through experiments in the labs and trials in the real world. However, new technology comes with responsibility, and proper patient counseling prior to any procedure helps to define the risks and benefits of all surgeries, including those involved in mesh repair of hernia throughout the body.

Mesh is a common and safe synthetic product that can be surgically placed in many areas throughout the body to reinforce a hernia or defect that occurs over time or as a result of injury. The classic example is a groin or inguinal hernia in a man. It is painful and can occur in 10 percent of men, usually after repetitive straining. A mesh patch or plug is placed through a small incision and reinforces the weak tissue and significantly reduces recurrence rates. It has been widely adopted by general surgeons over the last two decades.

Repairing or lifting dropped pelvic organs have been common surgeries in women. The most common is the bladder (cystocele), but the uterus, small intestine or rectum can also drop and push out the vagina. It can be painful and lead to urinary and defecatory problems, pain with sex and other issues. Many surgeries have been devised to “lift” the bladder, but unfortunately, recurrence rates for cystocele repair is quite high, approximately 30 percent at four years. It is the most common organ to drop after hysterectomy. Naturally, mesh has been considered to reinforce these repairs to reduce recurrence rates and prevent an unnecessary second, and even third, operation.

Many types of mesh exist, and not all mesh are created equal, nor appropriate for the vagina. Some mesh are synthetic and others are biological, from human or animal. The ultimate questions when approaching a patient with pelvic floor weakness, such as stress incontinence or bladder drop, are: Is surgery indicated, what type of surgery is indicated, what are the alternatives, how is the surgery to be done and what are the complications that go along with it, is the surgeon comfortable and highly trained to perform it, and is the patient’s condition appropriate in order to place mesh?

There has been an explosion and revolution in women’s pelvic health in the last decade, and many mesh products are available to the physician to choose from to fix incontinence and dropped organs. Subjects that older women were embarrassed to discuss are now out in the open, and since women are living longer and healthier with more active lifestyles, there is a demand for sustaining and improving quality of life in regards to the bladder. Incontinence affects a woman’s self esteem and is restricting. Women often will stay at home in order to avoid embarrassing odor or accidents in public, will not socialize and avoid sex. It’s a common an underreported problem with less than half of women even bringing it up for discussion with their family doctor.

The TVT (tension-free vaginal tape) mainstreamed mesh into common use for correcting stress incontinence. It has been on the market since 1996, with millions done worldwide. It is relatively easy to place, is minimally invasive, has a short recovery period, a low complication rate and high success rate. Most urologists and gynecologists now use some type of TVT copycat to treat stress incontinence.

The question is then asked: can mesh for bladder repair, or other pelvic organs, do the same thing?

Add a Comment7 Comments

EmpowHER Guest

I had this surg/in 2008 I still have lots of pain,and a awful odor what and why is it like this for I can't stand myself I told my doctor but nothing was done what should I do how can I find out if this mesh is the cause

February 2, 2011 - 12:16pm

Not sure if its an allergy to the mesh or if I have developed a bacteria infection which is causing lots of inflamation. The pain is immense. Other women should be warned of the side effects!!

February 28, 2010 - 8:00am

I had this surgery. It fixed the leakage problem mostly. I am very concerned with inflamation which has encompassed my whole lower body since the operation in November. All my joints are filling up with fluid which makes life excruciatingly painful. Severe arthritis conditions. I think its related!!! Someone should do a study on it.

February 28, 2010 - 7:56am
EmpowHER Guest

This article can be quite misleading. It is now known that transvaginal mesh is creating many complications for women worldwide. It is no longer considered safe.There are already 3 FDA warnings, Oct. 2008, Feb. 2009 & March 2009 about it.It was approved by the FDA with no testing based on previous similar products which have since been recalled from the market.As a result women are having repeated infections, pain, erosion and repeated surgeries to try to help the problems caused by it. There are even surgeons who have now started specializing in the removal of this dangeroous product.

October 21, 2009 - 9:19pm
EmpowHER Guest

I have worked for one of the most experienced Laser Vaginal Rejuvenation trained surgeons in the country. She worked closely with a urologist that successfully used the TVT sling to correct SUI. Our patients chose the TVT sling because of how tiny and natural it felt. http://vaginal-surgery.info

July 23, 2009 - 4:15pm

I just had my second bladder lift surgery in 4 years and at my 3-week appointment the doctor said everything looked great. The next day I was constipated and did far too much pushing (according to after-surgery Dos and Don'ts) plus my husband just got a new motorcycle and I've been on that 3 times since my first post-surgery checkup. The first two times resulted in no pain or discomfort whatsoever, but last night's ride caused me to have severe urination pain when I got home and just an all around feeling that something isn't right. I never asked my doctor how tight they actually "tie" the silicone mesh and the post-surgery Dos and Don'ts doesn't say much of anything about after the 3 week recovery period. I made an appointment for Monday, but am going crazy wondering if I've blown the whole thing and will have to pay for another whole surgery, since I was stupid enough to not lay back in a recliner and take short walks for the entire 4-6 week recovery period. Can anyone ease my worry over this 4th of July weekend? How easy is it for the mesh to break free and my bladder to fall again? Would one bout of constipation and 3 motorcycle rides (hitting a half dozen or so hard bumps) be enough to pull my bladder away again? Thanks. Debbie, Topeka, KS

July 2, 2009 - 12:46pm
EmpowHER Guest
Anonymous (reply to bigsims)

After having the surgery redone, early exposure to certain situations such as motorcycling riding is not such a great idea. Mesh is strong, but it isn't perfect. I'm curious which silicone product yout doctor used.

August 8, 2009 - 5:53pm
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