Montgomery, Ala., physician Dr. Jefferson Underwood is encouraging women to consider other options besides transvaginal mesh to treat specific gynecological problems.
Transvaginal mesh, also known as vaginal mesh or bladder sling, is a type of surgical mesh that looks like a fishing net. It is usually made of metal, fiber or pastic. The mesh was first used in the late 1950s for hernia repairs to keep internal organs from bulging through the surgical incision after surgery.
Fast forward 20 years, and surgeons began using the mesh to treat specific pelvic floor disorders, such as pelvic organ prolapse or stress urinary incontinence. These conditions are common in women and are generally caused by weakening of the muscles due to age, childbirth or obesity. The mesh was implanted through the vagina to keep the pelvic organs from protruding.
“It is estimated at the height of its popularity, over 100,000 procedures using transvaginal implantation were being performed in the United States alone,” Underwood wrote in a column in the Montgomery Advertiser.
In 2008, the Food and Drug Administration (FDA) identified an increasing number of adverse events in women who had undergone transvaginal mesh procedures. The most common complication was vaginal bleeding. Other complications included a recurrence of prolapse and incontinence.
“All of these conditions, as you can imagine, can not only cause physical problems, but emotional ones as well,” Underwood writes. Hundreds of women have filed lawsuits against the makers of transvaginal mesh claiming they were never told that the devices could injure them so severely.
“As a result, the FDA is now asking for careful consideration of other treatment options prior to the implantation of mesh transvaginally. This is because the mesh is a permanent implant and may not be able to be removed if complications should occur,” Underwood writes.
Underwood recommends women look first at nonsurgical options, such as weight loss and exercising, and Kegel exercises. Some techniques, such as electrical stimulation or the use of a vaginal cone may also prove beneficial. There are also other surgical procedures that can be considered as a last resort, such as urethropexy, or the insertion of a sling through the vagina; a sling made from the patient’s own tissue; or transvaginal tapes.
“The bottom line is that before you run off and have any type of major procedure done, it is first best to try nonsurgical options,” Underwood writes.
Source: Montgomery Advertiser