There are a few reasons why your doctor might suggest that you get the surgery to have a uterine mesh device, also known as trans-vaginal mesh. Any type of surgery can be a scary one, but knowing what the risks are associated with the surgery you are planning to have performed is very important. Before deciding if getting a uterine mesh device is really for you, you have to weigh the risks versus the benefits of getting one.
A uterine mesh device is made from either synthetic material that can be porous and absorbable or non-absorbable, or absorbable biologic material. Uterine mesh devices are generally surgically implanted to reinforce vaginal walls that have been weakened, to repair pelvic organ prolapse, or to cure urine incontinence by supporting the urethra.
When the tissues in your body that hold your organs where they should be become weak or stretched, pelvic organ prolapse occurs. According to the FDA, 30% to 50% of women may experience pelvic organ prolapse in their lifetime, and only two percent of those women may show signs. When pelvic organ prolapse occurs, the bladder, the uterus, the rectum, the vaginal apex after a hysterectomy, and the bowel can protrude into the vagina and sometimes may even protrude past the opening of the vagina. These symptoms often occur after childbirth and menopause.
Another reason a woman may have been suggested to go under the knife for a trans-vaginal mesh device is due to stress urinary incontinence. These are often treated with a device called a bladder sling. Stress urinary incontinence is when you leak urine while doing physical activities, such as laughing, coughing, exercising or even sneezing. This can affect both women and men, but it is more rare for it to affect men. Two muscles are used to control urination, and when one of these muscles is weaker than the other, accidents happen. It is more common in women because things like pregnancy and childbirth weaken these muscles.
The risks associated with these uterine mesh devices vary in severity. The FDA listed the most frequent complications with mesh surgical devices to be mesh erosion through the vagina, pain, infection, bleeding, pain during sexual intercourse, organ perforation, and urinary problems. Less common problems, but still notable, included recurrent prolapse, neuro-muscular problems, vaginal scarring and shrinkage, and emotional issues. In two years, the FDA had received 2,874 total complaints about mesh devices used to treat pelvic organ prolapse and stress urinary incontinence.
Of these, however, one of the most severe complications associated with mesh devices is when sharp edges of the device itself cuts through tissues in the pelvic region, or slices into main organs like the bowel or bladder. There are other methods to correcting pelvic organ prolapse and stress urinary incontinence, though. The older method of correcting organ prolapse is known as a colporrhaphy, but since this method has a risk of the problem reoccurring, many doctors will not perform this surgery and instead opt for using the mesh devices. The Burch procedure is used to treat stress urinary incontinence, where the surgeon will use the patients own tissue and repair the problem. Since the increase in the risks associated with bladder swings is continuously rising, many doctors are thankfully going back to using this method. In 2011, after the FDA issued a statement on the dangers of trans-vaginal mesh devices, they had also concluded that the devices have no greater benefits over the traditional methods of repairing these problems. This lead the FDA to order 44 different mesh producing companies to do a three year safety and effectiveness trial on their trans-vaginal mesh devices.
The FDA also encourages anybody who is recommended to get a mesh device to ask their doctor some questions beforehand. Asking if there is another method to fixing the problem without the use of a uterine mesh device would be one of the more important questions. Also, understanding why your doctor is recommending for you to use a mesh device instead of another type of surgical procedure would be extremely beneficial to you. Other questions include – what are the pros and cons of using surgical mesh in my particular case? Will my partner be able to feel the mesh device during sexual intercourse? What if the surgical mesh erodes through my vaginal wall? If I must use surgical mesh, how often have you used this particular product? What were the results with the other patients you have implanted this product in? And which specific side effects should I report to you after the surgery? For the full list of questions, as well as tips to after surgery care, visit FDA.gov.