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Transvaginal Mesh Perforation Symptoms and Diagnosis

Transvaginal mesh is commonly used to correct the symptoms of stress urinary incontinence (SUI) and pelvic organ prolapsed (POP). After childbirth, a hysterectomy, or weight gain, women suffering from SUI may experience urinary leakage while laughing, coughing, sneezing or lifting. With POP, organs like the bladder or rectum may begin to sag through weakened pelvic muscles, creating pressure, pain, and sexual difficulties. Often, women seeking medical help for these problems are treated surgically with transvaginal mesh to provide additional support to the pelvic muscles. With this approach, incisions are made through the vaginal wall to insert the mesh.

The mesh is often made from synthetic, non-absorbable materials like polyester. Synthetic mesh used in transvaginal pelvic surgeries was marketed as a strong and reliable device. Unfortunately, many women are currently experiencing problems after transvaginal mesh surgery, including mesh perforation.

Common Problems with Transvaginal Mesh

The Food and Drug Administration (FDA) has issued warnings about the use of mesh in transvaginal surgeries to correct SUI and POP. The FDA concluded that there’s no evidence that the risks of using mesh outweigh the benefits, and that using mesh to correct weakened pelvic muscles can be dangerous. Studies have shown that transvaginal mesh often erodes, or breaks down, causing it to move out of place. Sharp mesh fragments can injure surrounding areas causing pain, bleeding, and infection. The edges of these mesh fragments can even puncture internal organs – a complication known as mesh perforation.

 What Is Mesh Perforation and What Are the Symptoms?

The organs at risk for mesh perforation include the bladder and urinary tract, the bowels (rectum, colon, lower intestines), and the blood vessels in the pelvic region. Although punctures may be caused by defective mesh, improper mesh placement or surgical technique may also be the cause. Symptoms of perforation may vary according to the organs involved:

  • Bowel
    • Abdominal pain
    • Large or swollen abdomen
    • Vomiting
    • Inability to pass gas
    • Bloody stools
    • Vaginal discharge of fecal matter
    • Blood pressure changes
  • Bladder
    • Pain when urinating
    • Inability to urinate
    • Blood in the urine
    • Severe pelvic cramping
  • Blood Vessels
    • Blood in the urine or stool
    • Excessive vaginal bleeding
    • Generalized weakness
    • Abdominal swelling
    • Pressure

If left untreated, these complications can quickly lead to fever, chills, increased heart rate, sepsis (widespread infection), and death.

How Is Organ Perforation Diagnosed and Treated?        

The diagnosis of organ perforation may require a thorough physical exam, blood work, urine and stool testing, CT scans, ultrasounds, and cystography (visualization of the bladder using a scope). The treatment of perforated organs and vessels are somewhat similar but will vary based on where the injury occurred and the extent of the damage.

If transvaginal mesh is found to be the causing the damage, surgery may be necessary to remove or trim it. Antibiotics will be prescribed to control any infections. The hole in the bladder or bowel will be sewn closed and any ruptured blood vessels may be cauterized.

Additional interventions are often necessary. In the case of bowel perforation, any fluid or feces that has leaked into the abdominal cavity must be removed. For the bladder, a catheter may be inserted to drain urine that has been released. Blood transfusions may be necessary in the case of excessive or prolonged blood loss.

If you’ve had transvaginal mesh surgery and are experiencing any of the symptoms connected with mesh perforation, you should contact your doctor. Several mesh products, including those made by Johnson & Johnson and Boston Scientific, have been removed from the market due to dangerous defects. In several cases, these companies have been held liable for damages related to any medical expenses, lost wages, and pain and suffering that resulted from the injuries.