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Medical Diagnosis

Women who suffer from pelvic organ prolapse (POP) or stress urinary incontinence (SUI) may experience urinary leakage, loss of bowel control, intense pressure, and pain. Not only are these problems annoying and embarrassing, they can greatly impair quality of life. In order to correct these problems, tens of thousands of women have had transvaginal mesh surgery.

Unfortunately, transvaginal mesh has been linked to a number of painful complications in recent years.  These complications often require patient to undergo transvaginal mesh revision surgery, or removal of faulty mesh. This surgery carries dangers of its own. Below, you’ll find answers to common questions about mesh revision surgery.

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Q:  What is transvaginal mesh?

Transvaginal surgical mesh is a small flexible screen that’s implanted through the vagina in order to provide support of weak pelvic muscles. Synthetic polypropylene mesh is a popular choice among surgeons. Since the mesh is inserted through the vaginal walls, the surgery is said to be performed “transvaginally.”

Q:  What are the problems associated with transvaginal mesh?

Mesh has been used safely and effectively for decades in hernia repair. However, when used transvaginally, surgical mesh can lead to a number of problems. Vaginally placed mesh can attract infection, or be rejected by the body. In addition, the mesh can harden or shrink, causing it to break apart into sharp fragments. These fragments can cut the surrounding tissue and even puncture nearby organs. Due to the high number of reported complications, the Food and Drug Administration (FDA) has issued warnings about the transvaginal use of mesh.

Q:  What are common symptoms of mesh failure?

Mesh can fail within a few months after it is implanted. With mesh erosion, hardening, or shrinkage, the following symptoms have been reported:

  • Generalized pelvic pain
  • Painful urination
  • Dyspareunia or pain during intercourse
  • Blood in the urine or stool
  • Vaginal discharge which may include fecal matter
  • Fatigue
  • Feeling a “poking” sensation
  • Abdominal swelling

When early symptoms are ignored, sepsis – a dangerous, body-wide infection – can occur. In addition, prolonged or uncontrolled bleeding can lead to blood pressure and heart issues, and eventually multi-organ failure.

Q:  How is transvaginal mesh revision surgery performed?

While some mesh problems can be treated conservatively by applying estrogen creams or trimming exposed mesh, revision surgery or complete removal is necessary in many cases.  Since tissue, blood vessels, and nerves can grow through the mesh, removal is a delicate procedure. In cases of simple erosion through the vaginal wall, the mesh may be removed in an outpatient setting with a local anesthetic. If mesh has punctured or moved into the bladder or bowel, traditional surgery and hospitalization to repair vital organs will be necessary. The surgeon may then place a different, safer mesh in the vagina, before re-sewing the area. Antibiotic therapy is often started to prevent infection.

Q:  What are the complications involved with mesh revision surgery?

As with any surgery, mesh revision carries risks. Most often the risks are related to anesthesia, uncontrolled bleeding, and blood clots. After removal, scarring and atrophy can leave the vaginal muscles rigid and numb, making sexual intercourse difficult or impossible.  After repeated attempts at excision, some mesh fragments may remain in the body, forever preventing the patient from achieving a full recovery. Even in cases where the mesh is fully removed, the original symptoms of prolapse and incontinence often reappear.

Q:  What is the recovery process like after transvaginal mesh revision surgery?

Recovery from transvaginal mesh revision surgery depends on the extent and location of the damage. However, most of these procedures require a hospital stay of one day or less. Spotting, pain and fatigue are expected, but will usually improve in time. Walking is possible and encouraged immediately, but lifting and heavy exercise should be avoided for two to three weeks or as instructed by your doctor. No sexual intercourse is advised for six weeks. Most patients will return to work after six weeks as well.

Q:  What should I do if I’ve experienced mesh complications?

Problems with transvaginal mesh should be reported to your doctor immediately. Failure rates are unusually high among certain mesh devices, including those manufactured by Johnson & Johnson, Boston Scientific, and C.R. Bard. These companies may be liable for damages related to transvaginal mesh revision surgery. You should consult with a lawyer to learn more about your legal options.