Transvaginal Mesh Implants
Women suffering from Pelvic Organ Prolapse (POP) and Stress Urinary Incontinence (SUI) found relief with the advent of Transvaginal Mesh (TVM) implants in the 1990s. This medical mesh product originally was developed to repair abdominal hernias in the 1950s and has evolved into a treatment for women's gynecological problems. Despite its medical history, TVM has not cleared enough safety hurdles — a dangerous fact that has become evident by the widespread complications of the device.
What is Transvaginal Mesh?
TVM is a woven fabric that typically is used as a sling to support organs in the pelvic area, such as the bladder, urethra, uterus, top of the vagina, rectum and bowel. These organs need to be held in their normal positions in order to function properly. In some cases, the organs have slipped enough to protrude through the vagina. POP and SUI in women are most often caused by weakened muscles from pregnancy and childbirth. The risk of both conditions increases with age and after menopause.
The mesh used in these surgeries is made from various materials: non-absorbable polyester or polypropylene, absorbable synthetics, animal tissues, human tissues or combinations of these items. In general, urologists use the polyester or polypropylene most often for female patients.
Types of Mesh Implants
In addition to identifying the materials used in TVM, the implants are classified by the procedure used to place the TVM sling in a woman's body. The U.S. Food and Drug Administration has approved several types of Transvaginal Mesh implants:
- Tension-free vaginal tape (TVT) sling: Polypropylene mesh tape is inserted through one vaginal and two small abdominal incisions and passed under the urethra. Instead of sutures, the TVT is held in place by the patient's body. This is typically an outpatient procedure with minimal pain and a short recovery period.
- Trans-obturator tape (TOT) sling: This surgery has become popular because it allows the surgeon to better control placement of the tension-free tape and it is not a "blind" procedure like TVT. It is used to support the bladder. Research has not yet proven it quite as effective as TVT though.
- Mini-sling: A metallic inserter is placed through a vaginal incision to align the mesh tape near the mid-urethra in the pelvic cavity. This eliminates the abdominal cuts, improving recovery time and the risks of nicking other organs during placement.
Unfortunately, the improvements in TVM materials and procedures have not eliminated the life-altering effects that thousands of women have suffered from these surgeries. Even the FDA warns patients that complications are not rare and that there is no proof that traditional surgical repairs are any less effective than TVM. In fact, the FDA currently is poised to reclassify TVM as a high-risk medical device.
If you are experiencing debilitating pain or other symptoms related to your TVM surgery, our patient advocates may be able to help you. Call us at 800-514-9716.