Transvaginal Mesh Surgery

For women suffering with pelvic organ prolapse (POP) or stress urinary incontinence (SUI), relief from the constant pressure and pain of prolapsed organs can't come soon enough. So when transvaginal mesh (TVM) is offered as a chance to correct the problem, it sounds too good to be true – an incision-free surgical option that can fix the symptoms quickly and painlessly. Today, TVM surgery has proven that it comes with even more associated risks and problems than its invasive counterpart.

TVM repairs are similar to traditional surgical options in the way they correct the prolapse problems but different in the way the surgery is conducted. A traditional surgical repair to a prolapse occurs through a four- to six-inch abdominal incision. TVM is inserted through the vagina. Both surgeries are aimed at hoisting internal organs that have fallen into the vaginal canal and sometimes through the vagina. However, unlike traditional surgery, TVM is known to erode once inserted and cause intense pain and infection. Worse yet, a TVM repair is reported to not actually fix the problem. It only creates new ones.

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Risks Associated with TVM Surgery

When a woman decides to have TVM surgery, she is typically already in a lot of pain from the prolapse. This organ slippage is known to happen in women who have undergone a hysterectomy, menopause, childbirth and who are older. The muscles that usually hold the uterus, bladder and intestines in place grow weak and loose, allowing organs to slip down. Experts say an estimated half of all women suffer from some form of prolapse.

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Some of the risks that come with TVM surgery can be applied to any surgical procedure: infection and pain. However, medical experts have determined that the risk with TVM is far greater than normal. Because TVM is made from a flexible but sturdy plastic, it is known to slice into nearby organs. In July 2011, the U.S. Food and Drug Administration (FDA) determined that the most common risks with vaginal insertion of the mesh is the device cutting through the vaginal walls and nearby organs, called mesh erosion. When this happens, the risk of infection skyrockets. If the TVM nicks the nearby bowel, the results can be devastating. The sharp mesh edges can also cause sustained bleeding and pain during intercourse for both partners. The mesh is also known to shrink once placed in the vaginal area, causing severe pain because of the contractions.

Repairing Defective Implants

Once a woman has TVM surgery and suffers the associated problems, the first thought it to have the device removed. But it isn't that simple. TVM is known to erode and deteriorate into the pelvic tissue, unlike the traditional surgical insertion method. The surgery itself, called revision surgery or excision, is very difficult and requires the skill of an experienced surgeon. Some surgeons liken the process of TVM removal to picking gum out of the hair. The device crumbles in nearby tissue. Sometimes it takes two or three surgical procedures to get every minute piece of mesh out. And sometimes all of it can't be removed.

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