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Pain During Sex and Transvaginal Mesh: What You Need to Know

Quality of life is important as we become older. Modern medicine allows many people to remain active and independent into their sixties, seventies, and beyond. Along with recreation, exercise, and travel, many adults expect to remain sexually active throughout their lives.

Age-related changes to our bodies are natural and can create special challenges. However, pain during sex is not considered to be a normal part of getting older. If you’ve had transvaginal mesh (TV mesh) implanted for the treatment of pelvic organ prolapse or stress urinary incontinence, painful intercourse may be a sign of a larger problem.

What’s the Problem with TV Mesh?

Surgical mesh is a flexible screen used to strengthen weakened muscular areas. Mesh is made of synthetic (plastics) or organic (animal-based) compounds, and sometimes a combination of the two. Marketed and manufactured by large companies like Johnson & Johnson and Boston Scientific, mesh was approved by the FDA for use in transvaginal surgeries in the 1990s. Soon after, however, complications were frequently reported.

Synthetic mesh was not originally designed for use in the vaginal wall. It can shrink, harden, and crack. If erosion occurs, sharp fragments of the surgical mesh can move and cut the vaginal wall or surrounding organs. In addition, contracted mesh can cause the vaginal canal to shorten. When plagued by repeated infections and pain, life can become miserable. In addition, pain during sex may occur.

Pain During Sex and Other Symptoms of Mesh Failure

When mesh has become exposed in the vagina, a definite poking sensation may be felt by both the patient and her sexual partner. A deeper, more generalized discomfort may also be felt during intercourse. Other symptoms of transvaginal mesh failure include:

  • Foul smelling vaginal discharge
  • Repeated urinary tract infections (UTI)
  • Abnormal bleeding or spotting
  • Pain or trouble with urination
  • Pressure, which may or not be constant

Diagnosis and Tests

In many cases of mesh erosion through the vaginal wall, the doctor can see and feel the exposed transvaginal mesh during a physical examination. If the doctor suspects that the mesh may have injured other organs, or that surgical removal is necessary, the following additional exams or tests may be required:

  • CT scan
  • KUB ( X-ray of the kidneys, urethra and bladder)
  • Ultrasound
  • Cystography (scope insertion to visualize the bladder)

What Are Treatments for Painful Intercourse Related to TV Mesh?

Doctors tend to start conservatively when treating intercourse pain related to TV mesh. In cases of small erosions through the vaginal tissue, use of estrogen may be initiated to stimulate blood flow and promote healing. If this proves unsuccessful, exposed mesh can be trimmed and the tissue re-sewn.

If symptoms persist or if significant tissue or organ damage has occurred, the mesh will be partially or completely removed. This surgery is often performed on an outpatient basis, under local anesthetic. Additional tissue, organ, or nerve damage, along with blood clots or uncontrolled bleeding may occur during mesh removal. On average, two to three surgeries are required to completely remove all of the mesh. Symptoms, such as pain during sex, may not improve immediately. Complete recovery can take as long as six months.

Next Steps

There are allegations that the FDA prematurely cleared surgical mesh for use in transvaginal surgeries. Transvaginal mesh had not undergone human testing before being placed on the market, and many patients were unaware that this procedure was considered experimental. Subsequently, many brands of mesh have been discontinued because of the high failure rates in TV mesh procedures.

In addition, some pelvic surgeons argue that implanting transvaginal mesh should not be performed because of the difficulty in keeping the area sterile during surgery. Normal vaginal bacteria can contaminate the incisions, causing infection and other problems.

Mesh revision surgery and recovery can cost thousands of dollars and be psychologically exhausting. Discomfort, disability, and pain during sex can also seriously impair your quality of life. While a doctor can help you decide your next medical course of action, you may be left with the question: “how can I afford to fix this?” Connecting with a legal professional can help you find out if the mesh manufacturer is liable for your injuries under product liability law.