Surgical mesh is a synthetic, permanent material made from polypropylene. It is stronger than the body's natural tissue and is frequently used to repair weakened tissue. The insertion of surgical mesh is a minimally invasive treatment for pelvic prolapse that effectively relieves pain and pressure in the pelvic area by placing a piece of soft synthetic mesh in the affected area to restore organ support. As a result of this procedure, patients can engage in their everyday activities without the discomfort and inconvenience of prolapse symptoms. Surgical mesh has been used in the past to strengthen abdominal hernia repairs. More recently, doctors are using mesh products to repair pelvic organ prolapse (POP) and as a surgical treatment of stress urinary incontinence.
Benefits of Surgical Mesh
Surgical mesh implants are an option for women seeking treatment for the symptoms of pelvic prolapse. The implant procedure surgically places a piece of synthetic mesh in the affected area to restore organ support. The mesh is intended to act as a supportive sling to maintain proper positioning and relieve any symptoms associated with prolapse. Over time, the natural tissues within the body grow over the mesh and strengthen the support of the organs.
The Surgical Mesh Procedure
The surgical mesh procedure is performed in a hospital setting while the patient is sedated under regional or general anesthesia. During the procedure, small incisions are made to insert the mesh through the vagina. The original positions of the prolapsed organs are restored and the mesh is secured in place. Depending on the cause for surgery, the mesh is permanently implanted to reinforce a weakened vaginal wall for POP repair or support the urethra or bladder neck for the repair of stress urinary incontinence.
Recovery from the Surgical Mesh Procedure
After the procedure, medication may be prescribed for pain. Patients will be able to return home a day or two after the procedure, and can usually return to work and other regular activities within three to four days. Full recovery takes about three weeks.
Risks of the Surgical Mesh Procedure
Due to many patients experiencing problems, there are complications that have been associated with surgical mesh implants. A common problem associated with vaginal mesh implants is mesh erosion, also called mesh extrusion. This occurs when the edges of the synthetic mesh cut through the vaginal lining and nearby organs. This can cause organ perforation, infection, bleeding, pain and urinary problems. Additional surgical mesh complications may include:
- Bowel perforation
- Vaginal pain
- Vaginal spotting or bleeding
- Vaginal shortening
- Painful sexual intercourse
- Pelvic pain
In some cases, because of complications, the mesh may need to be removed. Surgical removal of the the mesh device is often painful and difficult because tissue has grown within and around the mesh. Removal surgery has a long recovery period and a high risk of additional damage or infection. After a systematic review of scientific information regarding the safety and effectiveness of mesh surgery, according to their website, the FDA determined that there were serious complications associated with surgical mesh placed through the vagina to treat pelvic organ prolapse. The FDA has also stated that there are cases of recurrent prolapses, neuromuscular problems, vaginal scarring and emotional problems as a result of mesh implants.
Considerations of Surgical Mesh
Before considering the surgical mesh procedure for pelvic organ prolapse, the FDA has recommended that patients consider the following:
- The associated risks of vaginal mesh surgery
- Possible need for additional surgery due to mesh-related complications
- Other pelvic organ prolapse treatment options
Patients are advised to have a serious discussion with their doctor regarding the reason why surgical mesh was chosen as treatment for pelvic organ prolapse, and should discuss other options before undergoing this procedure.
- National Institutes of Health
- Centers for Disease Control and Prevention
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
- U.S. Department of Health & Human Services
- U.S. National Library of Medicine