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Transvaginal Mesh Erosion Symptoms and Diagnosis

More young women have little “accidents” when they laugh or sneeze than most people realize. It’s embarrassing and inconvenient. SUI, or stress urinary incontinence, is an annoyance your doctor probably said would just get worse over time. On the other hand, your rectum or other pelvic organs may have started to push into your vaginal wall, causing pressure, pain and sexual difficulties. Weakened pelvic muscles from childbirth, genetics, abdominal surgeries, and ever-present gravity, can cause these problems – known as POP, or pelvic organ prolapse.

On the advice of your doctor, you may have had transvaginal mesh implanted into your vaginal walls to correct either SUI or POP.  The surgery is sometimes performed through the abdominal area, but is now frequently done through the vagina itself. If you’ve experienced problems caused by mesh erosion, you may be wondering what went wrong and what to do next.

What’s Wrong With the Mesh?

Polyester and polypropylene are commonly used in the design of many current surgical mesh products. This type of mesh was originally thought to be strong and long-lasting. It was also expected to maintain its original shape and stay in place. Unfortunately, it has been commonly reported that the mesh erodes, breaking into small pieces that can cut and perforate the vagina, bladder, and bowels. The mesh material has also been reported to shrink, causing pain, damage, and infection to surrounding healthy tissue. Commonly reported symptoms of mesh erosion include:

  • Pain in the surgical area
  • Leakage or pain associated with urination
  • Bleeding
  • Recurrent bladder infections
  • Feeling a “poking” sensations or spasms in pelvic area
  • Pain during intercourse

Symptoms related to transvaginal mesh erosion can appear as soon as one month after surgery, and generally occur sooner than in surgeries where the mesh was implanted through the abdomen. If you experience any of the above problems you should contact your doctor immediately. Infection due to erosion can be serious and requires prompt treatment.

Diagnosis of Mesh Problems

Your doctor will do a thorough physical pelvic exam to find any potential damage caused by implanted mesh. Additional tests may include:

  • Ultrasound
  • Cystography (a bladder exam performed by a radiologist)
  • Colonoscopy (a procedure to examine the rectum and colon)
  • Blood, urine, and stool tests

Treatment Options

Surgery is often required to remove all or part of the mesh from the tissue that has grown in and around it. The procedure can be compared to removing tangled vines from a chain link fence. The removal process can be complicated and may take multiple surgeries. Incisions are made through the vaginal wall to remove the mesh, followed by re-sewing of the vaginal tissue. Any surrounding organs that have been punctured by the mesh will require repair as well.

Unfortunately, after mesh removal surgery, many of the original symptoms of SUI and POP can return, such as incontinence, pain, and pressure. Often, the muscles have been further weakened by the mesh erosion, causing some patients to feel worse than before the original surgery.

If you suspect you may have problems related to mesh erosion, talk to your doctor. Some types of mesh have higher failure rate than others, and are no longer being made. In addition, a number of patients have filed lawsuits against mesh manufacturers after experiencing complications related to mesh erosion. An examination of your medical records will reveal the type of mesh product that was used in your surgery.