Transvaginal Mesh


The words “transvaginal mesh” can certainly seem strange and scary at first, especially since there have been so many reports of medical problems caused by the treatment. However, there’s more to know about transvaginal mesh – what it is, what it does, and what can go wrong – than just what you overhear on the nightly news or read in an article posted on your favorite social media site. In fact, here is some detailed but clear information on just what people are talking about when it comes to stories regarding transvaginal mesh.

What It Is

A transvaginal mesh is a specific type of implant used in urogynecologic procedures. Surgical meshes are used to provide additional levels of support when damaged or weakened tissue is repaired through surgery, and surgical meshes come in two primary types: synthetic meshes made specifically from man-made materials and organic meshes made from specially-prepared animal tissue, often from a pig or a cow.

Surgical meshes, including transvaginal meshes, are considered either temporary in the case of absorbable meshes or permanent in the case of non-absorbable ones. Many synthetic meshes are either non-absorbable or are a combination of absorbable and non-absorbable; meanwhile, the majority of organic surgical meshes are absorbable and therefore temporary.

What It Does

In the case of transvaginal mesh, the most common use is to repair a condition known as pelvic organ prolapse, or POP. Transvaginal meshes are usually non-absorbable, permanent implants that are used to reinforce a vaginal wall that has become weakened in some way, typically through surgery or childbirth, to the point where it can no longer support the weight of nearby organs like the bladder.

Many women develop POP only to have the condition go away on its own as the vaginal walls recover from whatever strain weakened them. However, in several cases the vaginal wall will need to be reinforced through the use of a transvaginal mesh, which is intended to provide support to reduce the effects of POP and reduce the possibility of additional pelvic organs prolapsing in the future.

What Can Go Wrong

There are several different types of complications that can occur after having a transvaginal mesh implanted in order to treat POP. Problems began to come to light in 2008, when the US Food and Drug Administration first warned that these complications existed. After further research, the FDA announced in 2011 that these complications were not rare but actually quite common, adding that using transvaginal mesh to repair POP might not even be any more effective than traditional treatments that didn’t involve the use of surgical mesh.

The FDA has shown through research that transvaginal mesh treatment for POP can lead to a large number of different complications like bleeding, infection, pain (especially pain during sexual intercourse), the erosion of the mesh, urinary problems and even organ perforation. More than a few of these complications need to be treated separately, and in many cases this may involve an additional surgery to remedy the complication.

The FDA is currently considering the re-classification of transvaginal mesh as a device that carries a high level of risk, which would differ from the treatment’s current moderate-risk classification; this would not affect other kinds of surgical meshes used to treat POP, such as transabdominal meshes. The federal agency urges anyone who suffers from POP to thoroughly weigh all the available treatment options open to them before settling on the use of a transvaginal mesh, especially in light of the heightened risk for complications that may necessitate additional surgical treatments in order to rectify.

Sources:

Mayoclinic.org

FDA.gov

WebMD.com