Pelvic Mesh Implants: What You Should Know About Potential Side Effects

As with any medical procedure, it’s important to understand both the potential benefits and risks involved with pelvic mesh implants.

Used in treatments for conditions like pelvic organ prolapse and stress urinary incontinence, transvaginal mesh has helped many women regain control and confidence. However, stories have also emerged of severe complications that can diminish quality of life.

This article aims to provide objective information about vaginal mesh so readers can make informed decisions about their health.

What Is a Transvaginal Mesh, Afterall?

Transvaginal mesh is a surgical implant made from natural or synthetic materials to reinforce weakened pelvic tissue. The mesh is inserted minimally invasively to address conditions such as pelvic organ prolapse (POP) and stress urinary incontinence (SUI).

POP occurs as the muscles and ligaments supporting the pelvic organs stretch and weaken over time. This allows the bladder, uterus, or bowels to protrude into the vaginal area. SUI causes involuntary urine leakage during everyday activities like coughing, sneezing, or laughing due to weakened pelvic floor muscles. Both POP and SUI can significantly impact quality of life.

For POP, the implanted mesh acts as a supportive scaffold to return misplaced organs to their normal positions.

In cases of SUI, surgeons position a sling of mesh under the urethra through the vagina. By applying gentle upward pressure, the sling helps prevent unwanted urine loss from the bladder.

These transvaginal mesh procedures aim to restore continence and comfort through non-invasive correction of underlying pelvic floor weaknesses. The implanted mesh reinforcement provides an effective treatment option for many suffering from POP or SUI.

Applications of Transvaginal Mesh

Surgical mesh has several applications for treating pelvic floor disorders. It can be used to repair pelvic organ prolapse as well as stress urinary incontinence.

In cases of pelvic organ prolapse, there are abdominal and vaginal surgical options. Through a small incision in the abdomen, a surgeon may reinforce the weakened vaginal wall with a mesh implant.

Alternatively, traditional sutures can be used to repair damaged tissues through a vaginal incision. However, placing mesh through the vagina for prolapse is no longer recommended due to risks of post-operative complications.

For stress urinary incontinence, a common cause is too much pressure on the bladder during routine activities like coughing or sneezing. A mesh sling procedure can help by supporting the urethra to prevent leakage.

Surgeons may perform this as an outpatient procedure, implanting a mesh sling through the vagina or through two tiny abdominal incisions just above the pubic bone. Known as a mid-urethral sling, this operation provides additional strength to the tissues controlling urine flow.

In summary, while surgical mesh offers benefits for reinforcing weakened pelvic tissues, abdominal approaches are generally preferred over vaginal placements due to risks. To optimize favorable results, appropriate patient selection and surgical technique are crucial.

Why Is Transvaginal Mesh Risky?

While the majority of women undergoing transvaginal mesh procedures do not encounter issues, a significant number do face complications. These challenges can manifest either immediately after the surgery or emerge years later.

Complications range in severity from minor discomfort to excruciating pain. These can include inconsistent discharge from the vagina or bleeding, pelvic pain or edema, erectile dysfunction, and bowel and bladder issues like infection and incontinence.

Along with pain in the abdomen, buttocks, or legs, some women may also have a prickling sensation or intense stabbing pain in the vagina, which could get worse with physical activity.

When surgical mesh is employed through the vaginal route to address pelvic organ prolapse, there is a heightened association with mesh-related problems. These problems encompass instances of the mesh protruding through the vaginal wall, leading to pelvic pain and discomfort during sexual intercourse.

It is important to note that this type of surgery is no longer performed in the United States, emphasizing the recognition of safety concerns.

In cases where mesh is used for stress urinary incontinence or prolapse repairs, there exists a small probability of encountering other complications. Mesh exposure or erosion, when it extends past the surgical incision and into the vaginal canal, is one possible problem.

While most individuals with erosion may remain asymptomatic, those who do experience symptoms may report spotting, discharge, or discomfort for their partners during sex. Serious problems arising from these situations are infrequent.

For individuals facing mesh-related problems post-surgery, potential solutions include undergoing additional surgery for mesh removal or utilizing a specialized vaginal cream prescribed by a healthcare provider. In some cases, a procedure to trim an exposed segment of mesh may be recommended to alleviate symptoms and promote recovery.

Legal Issues

Many women sought treatment for pelvic problems, such as stress urine incontinence and pelvic organ prolapse, using transvaginal mesh implants. Regrettably, a number of these mesh devices turned out to be flawed, causing major harm and consequences like excruciating pain, infections, and immunological issues.

Therefore, individuals are pursuing vaginal mesh lawsuit cases with the dual aim of holding manufacturers accountable for defective products and obtaining compensation to cover medical expenses.

Such compensation becomes crucial for affording necessary medical care, particularly for revision surgeries and complications resulting from transvaginal mesh implants.

Plaintiffs in these cases claim that mesh manufacturers provided incorrect information about the efficacy and safety of their products to the medical community and the general public. To stop more injuries, regulatory agencies have removed several transvaginal mesh brands from the market as a result of these legal actions.

TorHoerman Law says that transvaginal mesh cases have resulted in large compensations, underscoring the urgency of the condition. A jury in Philadelphia awarded $120 million and $80 million in 2019 to two different women who had serious side effects from transvaginal mesh surgery. American Medical Systems also achieved a settlement of $830 million for 20,000 transvaginal mesh cases in 2014, making it one of the biggest.

These legal outcomes underscore the imperative of closely examining complications associated with transvaginal mesh procedures.

Exploring Alternative Treatment Options to Transvaginal Mesh

Instead of transvaginal mesh, individuals have several alternative treatment options available:

Pessaries 

A pessary is a silicone device inserted into the vagina to provide support to organs that have shifted out of place. It can also exert pressure on the urethra to prevent urine leakage.

Successful usage of a pessary ranges from 50–80% across females of various ages, medical histories, and conditions. This choice might be appropriate for anyone looking for a short-term or long-term fix for pee leakage while exercising. It is also appropriate for someone who would rather not have surgery performed and who has the time to take the device out and clean it on a regular basis.

However, pessaries may not be suitable for individuals with a widened vaginal opening, a surgically altered vaginal structure, or vaginal scarring. Additionally, they may not be recommended for those experiencing vaginal dryness or weak pelvic floor muscles.

Pelvic Floor Therapy

Pelvic floor therapy involves targeted exercises designed to strengthen the pelvic floor muscles. Collaborating with a physiotherapist offering pelvic floor training can be beneficial in this regard.

Biofeedback and Electrical Stimulation

Techniques like biofeedback and electrical stimulation can enhance the function of pelvic floor muscles, addressing issues related to pelvic organ prolapse (POP) and stress urinary incontinence (SUI).

Additional Treatment Options

Medications and lifestyle changes, such as maintaining a healthy body mass index, minimizing heavy lifting, and treating constipation or persistent coughing, are among additional treatment options. Bladder training and the use of absorbent items for SUI are also recommended.

Surgical Alternatives

Surgical alternatives include native tissue repair or pubovaginal sling, utilizing the individual’s tissue to address POP. Biological graft repair involves using human or animal tissue to support a prolapse. Bulking agents, injected into the urethra, serve as a treatment for SUI.

By exploring these diverse alternatives, individuals can make informed decisions about their healthcare, taking into account their specific needs and preferences.

In conclusion, transvaginal mesh can be an effective treatment for POP and SUI, but it’s important to be aware of the potential risks and complications. Making educated decisions about your healthcare requires weighing the advantages and disadvantages and looking into other options.