Why correcting incontinence with transvaginal mesh may be a bad idea

female bladder Why correcting incontinence with transvaginal mesh may be a bad idea Transvaginal mesh is often used in women suffering from stress urinary incontinence (SUI), a condition in which the muscles that help control urination weaken, allowing urine to pass involuntarily, sometimes with just the slightest of triggers, such as sneezing, coughing, or simply standing. But is transvaginal mesh the best choice for correcting SUI?

Transvaginal mesh is a flexible screen-like device made of synthetic plastic composites. It is implanted in the body in a way that repositions the pelvic organs (the bladder, uterus, bowel, etc.) so that they can function normally, usually in women who experience some degree of pelvic organ prolapse (POP).

If your doctor mentions a sling procedure, that is when the surgeon uses strips of mesh (or biological tissue) to create a sling around the bladder neck and urethra, providing support to keep the urethra closed. Women whose pelvic floor has been weakened by childbirth, hysterectomy, aging, or other factors sometimes develop SUI or POP – pelvic organ prolapse, which causes the bladder and/or other pelvic organs to drop and protrude into the vagina.

Doctors usually recommend that women with milder cases of SUI try making simple lifestyle changes first to correct the condition. Quitting smoking and exercising top that list, but if those solutions fall short, Plan B may likely involve surgery, sometimes with the use of transvaginal mesh.

If your doctor recommends using surgical mesh to shore up the bladder and other pelvic organs, consider the safety profiles of these devices first. Research the accounts of women whose lives have been diminished due to some malfunction of the surgical mesh. Know the risks before you consent to surgery that involves the use of mesh products.

Ironically, one of the complications of vaginal mesh products is stress urinary incontinence. Some women who have undergone surgery to correct SUI with surgical mesh have actually experienced a worsening of the problem they wanted to fix.

For others, the injuries may be severe and in some cases life-threatening. Transvaginal mesh can erode into the vaginal walls, causing intense pain and bleeding. The device can also puncture the bladder and other organs, set off internal infections, creating scar tissue, and cause dyspareunia or painful sexual intercourse.

While most women implanted with transvaginal mesh will experience no complications, the odds of becoming injured by the device are nonetheless extremely high. According to a study published in the American Journal of Obstetrics & Gynecology, one in six women who had vaginal mesh implants experienced complications 12 months after surgery.

Unfortunately, vaginal mesh complications are seldom easy to fix. Because the mesh is designed to become quickly incorporated into the surrounding tissue, several surgeries are often required to remove it completely. For some women, removal of the mesh is impossible, and pain management becomes their only treatment option.


U.S. Food and Drug Administration

The Mayo Clinic