Pelvic mesh is a type of synthetic netting used by physicians to treat various medical conditions in women. Most types of pelvic mesh are manufactured out of polypropylene and require a surgeon to insert the material inside the pelvis. Many doctors recommend pelvic mesh for medical conditions such as prolapse and stress incontinence. According to the Cleveland Clinic, approximately 200,000 women each year undergo mesh insertions. However, many of these women often develop complications and need to meet with a doctor to discuss treatment options, including pelvic mesh removal.
Pelvic Mesh Risks and Complications
The most common side effect of surgical mesh surgery is erosion. The synthetic material gradually erodes and will eventually dislodge from the vaginal walls. The mesh may start to protrude out of the vagina when erosion occurs. The decay could also cause injury to any surrounding organs and tissue. There have been incidences when the mesh has eroded into the rectum, bladder, or urethra. Potential symptoms associated with pelvic mesh erosion include:
- Persistent pelvic pain
- Sexual intercourse pain
- Frequent infections
- Pelvic organ prolapse recurrence
- Bladder problems
An additional complication with mesh surgery is vaginal mesh contracting. Over time, the mesh may shrink and tighten around the insertion area. When the mesh contracts, pain, and discomfort can occur due to vaginal shortening.
FDA Warnings for Pelvic Mesh
The risks associated with this type of mesh aren’t new findings. In 2011, the United States Food and Drug Administration released a safety warning about the risks associated with pelvic mesh. The FDA advised women that transvaginal mesh could affect their quality of life, and long-term side effects may occur. Complications from the procedure include an increased risk of infection, pelvic pain, incontinence, vaginal scarring, and bleeding. The FDA noted in the report that due to the complications, women could have a decrease in quality of life related to recurrent pain, frequent urge to urinate, and discomfort during sex.
Pelvic Mesh Removal
Depending on the severity of the complications from the mesh, the procedure may require reversal. A surgeon can remove all or part of the mesh. The type of surgical removal will depend first on the placement of the mesh. Surgeons may set the mesh over the rectum or under the bladder. A surgeon will typically perform a procedure called vaginal mesh excision. Some surgeons may not recommend removing all of the mesh. Instead, the surgeon may trim the material around eroded tissue or remove the arms of the mesh. In some cases, the surgeon may not be able to remove all of the mesh. This problem occurs when body tissue has already grown into the material.
A surgeon performs pelvic mesh removal surgery through the vagina. After mesh removal or partial mesh removal, the vaginal walls will require suturing. The stitches will bring together the tissue under the soft layer of the vaginal walls. Any skin damage during the procedure will also need stitching. Any tissue removed during the excision will be sent to a pathology lab for analysis.
Removing this type of mesh can prove challenging. Always speak to your doctor before a pelvic mesh insertion to fully understand the risks of the surgery.