The Truth About Vaginal Mesh
A lot of you have might have seen the attorney TV commercials on vaginal mesh. Synthetic meshes are sometimes used to correct vaginal prolapse (e.g. dropped bladder, uterus or rectum) and urinary incontinence. Vaginal meshes may provide increased success rates for prolapse and incontinence however it does not come without risks.
The most common complications for vaginal meshes include mesh exposure (i.e. feeling a foreign body sensation in the vagina), vaginal pain, vaginal scarring, painful sexual intercourse and others. The treatment options for vaginal mesh complications depend on the type of complication which may include hormonal cream application, surgical removal of the mesh and / or pelvic floor physical therapy.
Trans-vaginal meshes used to correct vaginal prolapse are usually larger in size and have a higher rates of the above mentioned complications. Patients should be counselled prior to their surgery in regards to the risks and benefits of using a vaginal mesh versus using only dissolvable sutures to correct the prolapse. Patients should be informed about alternatives ways to fix prolapse including non-surgical options. Some scientific authorities recommend that trans-vaginal mesh repairs should be reserved for the recurrent and / or severe cases of prolapse after appropriate patient counselling.
Meshes used to treat urinary incontinence on the other hand (aka mid urethral slings) are usually smaller in size and have generally lower complication rates compared to the larger ones used to treat prolapse. With appropriate patient counselling mid urethral slings still considered by many scientific authorities to be the standard of care for surgical correction of stress urinary incontinence. Mid urethral slings in general have high success rates to cure urinary incontinence with a generally low complication rate.
In summary the use of trans-vaginal meshes is not essential in surgical treatment of vaginal prolapse as there are other surgical options that can be done without the use of mesh. In our practice we do not use trans-vaginal meshes for prolapse repair. Instead, absorbable suture repairs may be offered depending on each case. We also offer mid urethral slings and trans-abdominal mesh repairs after extensive patient counselling as clinically appropriate. These have a much lower mesh complication rates as reported by the American Urogynecologic Society. We also specialize in treating vaginal mesh complications. If you are considering surgery for vaginal prolapse or suffer from complications of vaginal mesh please consult with a specialist (i.e. Urogynecologist) for proper counselling regarding treatment options.
Office Hours: Monday thru Friday: 9:00 am – 5:00 pm