Pelvic reconstructive surgery that involves a surgical mesh implant often comes with complications. In fact, some surgical mesh products are so hazardous, that the FDA has recently banned some of them altogether in the U.S.A. “Too little, too late,” cried FDA critics after the ban, as thousands of U.S. women had already developed life-altering pelvic mesh complications, with many of the sufferers and their families not even being aware of the true cause.
What is a Surgical Mesh?
A surgical mesh is a medical device routinely used in the reconstructive surgery of the pelvic floor. The thin polymer sheet is used to offer extra reinforcement to vaginal walls and weakened and damaged internal organs and tissue during surgery.
While some surgical mesh products are designed to be resorbed over time, most of them are made of polymers that stay put. If complications occur, the latter need to be surgically removed.
Types of Surgical Mesh Products
Both absorbable and non-absorbable surgical mesh products come with their fair share of risks and complications. That’s why mesh manufacturers use a wide variety of materials and designs in a bid to get it right.
The most common surgical mesh products are made of
- Polypropylene (a synthetic polymer, aka plastic, that doesn’t resorb over time)
- Polyglycolic acid or polycaprolactone (synthetic polymers that resorb over time)
- Acellular collagen (absorbable, it is usually sourced from cow or pig tissue)
- Composite (absorbable and non-absorbable, it is made of a blend of the above materials in a bid to minimize risks)
Surgical Mesh Risks
When it comes to these medical devices, there’s no perfect product. The mesh products that are too porous, usually made of polypropylene or polyester, may lead to complications such as obstructions or bowel adhesions because the large pores permit scar tissue in-growth.
Mesh products with smaller pores do not allow for risky tissue in-growth, but they are more prone to bacterial proliferation and encapsulation by nearby tissue. When a bacterial infection occurs, these mesh products must be surgically removed.
The safest products are those made of composite materials that allow for a safe dose of scar tissue in-growth but come with an anti-adhesive layer to reduce the risk of infection and tissue adhesion to the material.
Unfortunately, very few surgical mesh manufacturers have been able to prove the long-term safety of their products, which is why, in April 2019, the FDA banned all surgical mesh brands for transvaginal repair of Pelvic Organ Prolapse (POP) from being used or sold in the U.S.A.
Fortunately, POP reconstructive surgery can be performed without a surgical mesh, which is a safer procedure in the long run.
Surgical Mesh Complications: Most Common Symptoms
The most common symptoms of pelvic mesh complications include:
- Pain and tenderness around the mesh repair
- Vaginal bleeding
- Vaginal discharge
- Bacterial infection
- Chronic inflammation
- Painful sexual intercourse
- Recurring pelvic organ prolapse (POP)
- Recurring Urinary tract infections (UTIs) – many doctors have misdiagnosed mesh-related bacterial infections and mesh erosions as a UTIs
- Vaginal mesh erosion – this one is the most common complication after POP repair surgery especially in non-absorbable, rigid meshes such as those made of polypropylene or polyester
- Vaginal mesh encapsulation, which may lead to vaginal pain, shortening, and tenderness
- Tearing of internal organs
- Vaginal mesh-related emotional issues, including depression, anxiety, and feelings of hopelessness and abandonment
- Irreversible damage, scarring, and loss of function of the vagina, bladder, or urethra even when the mesh implant had been done years before.
What Are Some of the Safer Alternatives?
The POP repair can be performed with stitches alone, without the need for the surgical mesh. Surgeries for stress urinary incontinence (SUI) do require a mesh sling but the risk of complications is much more reduced than in POP repair. Seventy to 80% of SUI procedures are usually deemed a success within one year following the reconstructive surgery.
The safer alternatives to surgery for SUI or prolapse include pessaries and Kegel exercises to strengthen the pelvic floor muscles. There are also mesh products made of 100% absorbable biologic material sourced from the tissue of the patient.
Talk with your doctor to learn about all your options.
Although medical devices revolutionized medicine, technical errors do occur and impact patients’ health in ways not even patients are fully aware of. Surgical mesh products are no exception, as countless cases of women maimed for life by a defective medical device have shown.
Before opting for pelvic reconstructive surgery, it is best to consult with a doctor (or two) to see what your options are. Also, if the damage has been done, get immediate medical attention, and consult with a lawyer too to help you get fair compensation.