Pharmaceutical

New study finds removal of transvaginal mesh may pose further injury

vaginal mesh sling New study finds removal of transvaginal mesh may pose further injury  A new study published in the September issue of American Journal of Obstetrics and Gynecology warns that women who experience complications from transvaginal mesh devices may be putting themselves at risk for further injury and complications by opting to have the mesh surgically removed.

The report, prepared by the Mayo Clinic and and Spectrum Health Medical Group in Michigan, offers little comfort to the thousands of women experiencing intensely painful and debilitating transvaginal mesh injuries. Because transvaginal mesh devices are designed with thin polypropylene mesh to become integrated with surrounding tissue, complete removal can be very tricky, if not impossible.

Moreover, given the location of the transvaginal mesh and the nature of the surgery required to remove it, the patient risks having her uterers, the tubes that carry urine from the kidneys to the bladder, damaged, the report’s authors write.

Transvaginal mesh was designed as a less invasive alternative to more conventional surgeries in correcting pelvic organ prolapse (POP) and stress urinary incontinence (SUI). Both conditions, marked by weakened pelvic muscles, are generally brought about by age and childbirth. Transvaginal mesh is named so because it is inserted through the vaginal canal and set in place to shore up the weakened muscles and keep the pelvic organs in place.

Complications linked to transvaginal mesh, which the U.S. Food and Drug Administration (FDA) has warned are more common than previously thought, may happen when the device erodes through the vaginal wall, shifts, or breaks apart. Any of these complications may damage tissue and organs, resulting in constant or near-constant severe pain, bleeding, and infection.

Many women who suffer from transvaginal mesh complications can no longer engage in sexual relationships and must rely on prescription painkillers to manage their pain. Recurrence of prolapse and incontinence are also common when transvaginal mesh devices malfunction.

The Mayo study reports that up to 14.5 percent of woman implanted with transvaginal mesh will experience one or more of these complications. Although the study’s authors do not know what the rate of urinary tract injury during transvaginal mesh removal is, they conclude that all patients experiencing complications should “be counseled on all options” for treatment before deciding on surgical removal.

Source:

Ureteral injury during vaginal mesh excision: role of prevention and treatment options