Vaginal Mesh Problems

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Problems with Vaginal Mesh?

Vaginal mesh represent synthetic hammocks that are ideally supposed to fix urinary leakage. Mesh can also fix organs that are falling out, a condition called prolapse. Most surgeries go well. Unfortunately, a small percentage of vaginal mesh implantations can cause problems.

What are symptoms after transvaginal mesh implant surgery?

Surgery using mesh is done to fix pelvic prolapse (falling out bladder or vagina) or urinary leakage. We call these surgeries sacrocolpopexy, anterior repair, posterior repair, and urethral sling repairs. All these surgeries have variations and can use mesh. Normal symptoms after surgery usually go away by 6 weeks. This can include pain and some vaginal bleeding. Urination is usually normal right after surgery.

Sometimes, pain persists or starts to become a problem months after the procedure. Pain can occur during activity. Many times, the pain is during sex. Husbands or partners sometimes can feel the mesh and also complain of pain. These problems lead to social isolation and problems with intimacy. Women can gain weight because they no longer are active. Marriages undergo stress due to the lack of sexual intimacy.  In general, there are a couple of types of problems. Read more

What is being done to fix the problem?

Removing vaginal mesh can be difficult. Mesh was not designed to come out. Many surgeons rightfully avoid mesh removal surgery due to potential risk of injury. Finding an experienced surgeon is important.

Physical therapy and medical therapy are also used to help address mesh-related issues. Medication such as estrogen can help rebuild the vaginal wall and treat minor cases of erosion. Physical therapy can help with abdominal or pelvic pain. However, for some, these treatments are not enough. These women could even undergo surgery to attempt removal of the mesh. Read more


Questions and Answers Regarding Vaginal Mesh Revision Surgery

Dr Kella became interested in mesh removals when a patient asked if he could robotically remove a mesh erosion. The case was similar to fistula cases. A fistula is a situation where an abnormal connection between organs exist. For example, a connection between the bladder and vagina. Some cases can be done through a vaginal approach. These cases can be difficult and patients have come from around the United States to have their mesh removed by Dr Kella.

Many women do fine from their surgery. The problem is that manufacturers pushed mesh as a solution for all doctors to solve all problems for all women. Once manufacturers realized that this was a problem, not enough was done to reeducate physicians. Too much had been invested to recall the product.

Even I was skeptical at first. However, after seeing marriages ruined, women seeking psychiatric help, and women having to go from doctor to doctor, I realized the problem was real.

Pain, infections, and continued urinary issues are the most common complaints. Pain can be with intercourse and can even affect the spouse. This leads to obvious problems with intimacy. Relationships can be ruined. Pain can also be with movement or exercise. The pain can after right after surgery. Othertimes, it starts 6 to 9 months later after surrounding nerves become entrapped in scar tissue. The pain can be chronic. The vaginal mesh can cause lower back pain.  Women lose interest in social activities. The pain and the inability of doctors to understand compound a woman’s frustration. Urination becomes more urgent or frequent. Some women have to push themselves forward to try to urinate.

Yes. However, we are using mesh for sacrocolpopexy. I use the robot to do this surgery. There should be less risk of problems when the surgery is done this way. Transvaginal mesh for prolapse is something that only high volume surgeons should do. I will use small mesh or transobturator tape slings. We are exploring the use of laser therapy to treat mild incontinence or vaginal atrophy.

Pain is usually improved after surgery. 60% report an improvement. Urinary problems are more difficult to predict. Most women maintain their continence with cough or sneeze. The urgency can get better if it was not a problem prior to surgery. Erosions where the mesh protrudes through the vagina is not an issue once it is removed. We usually recommend estrogen cream as long as there is no breast cancer history. In addition, vaginal laser treatment can be every effective for revitalizing the vaginal tissue.

A listing of different TOT systems


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A San Antonio urologist, Naveen Kella M.D. is the Founder of the Urology Place. He is one of the most experienced surgeons in the country with robotic prostate cancer surgery.

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