Vaginal mesh implant is a common treatment in women above the age of fifty who experience incontinence or pelvic organ prolapse. A synthetic net-like substance, known as the transvaginal mesh is used to provide extra support to the damaged internal tissues.
More than 200,000 inpatient surgical procedures are performed in the U.S. every year to treat Pelvic organ prolapse (POP) amongst women. About 13% of those who undergoes the surgery would require repeating the operation within the next five years while 30% of them would undergo another surgery for a related prolapse condition in their lifetime. While the FDA has classified transvaginal mesh as a high-risk device and vaginal mesh complications remain to be one of the most commonly reported problems, some surgeons continue to use it.
Troubles with vaginal mesh
Traditionally, the pelvic organ prolapse surgery involved repairing the torn connective tissues with sutures which was named vaginal repair. As the procedure had high chances of the prolapse recurring, this is when the doctors introduced a mesh-like product to treat the condition. The Therapeutic Goods Association (TGA) approved the transvaginal mesh kits from 2003 although there was little knowledge about the safety and efficacy of these kits initially.
Certainly there are some advantages of the transvaginal mesh over traditional vaginal repair- reduced symptoms of prolapse being one of them. However, there are some severe vaginal mesh complications.
Mesh erosion
Of the many drawbacks, mesh erosion is a major concern. Although this occurs in 5 – 7%, it becomes very difficult to correct the situation. Painful voiding, hematuria, urinary frequency, urgency, recurrent urinary tract infection and urinary fistula are some of the common symptoms of mesh erosion into the bladder. Tell your urogynecologist immediately if there is any of the above symptoms persists.
There is no fool-proof guarantee on the meshes supplied by the pharmacies to be the best in quality. There is lack in mesh testing and manufacturers do not abide by the same rules always. Some women might be allergic to the polypropylene plastic which makes up the mesh. The allergic reaction might lead to chronic pain and inflammation when the only viable option remains to remove all the pieces of the mesh.
About 14% of the cases have reported about mesh rubs wherein the vagina is exposed. While some women had no symptoms of the exposure others faced discomfort, bleeding and pain during intercourse. Surgical correction is required for such women and is generally successful.
Recent concerns on vaginal mesh complications
For a site specific repair amongst the younger women, a good quality of collagen is preferred; however, if the quality of collagen is not up to the mark, a mesh is more preferable. Although the meshes apparently seem to be an easy surgery, it is difficult to find a skilled surgeon who could minimize the post-operative complications. The recent FDA recommendations found that meshes are not the main problem but the surgeons. Unless the surgeon performing the operation is not entirely skilled in laparoscopic surgery as well as promontofixation, chances are less that a fair option between the vaginal versus laparoscopic surgery will be offered to the patient. Also, the skills of the surgeon are never assessed and the FDA demands for a mandate on video registration.
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Transvaginal Mesh Financial Compensation 