Mesh is a synthetic graft used to augment surgical repair. Pelvic surgeons started incorporating the use of mesh to make repairs more durable. Unfortunately, using additional graft has risks for complications. In 2011, the FDA released a safety warning in regards to mesh use in pelvic surgery.
Not all mesh products are the same. Mesh is commonly used for stress urinary incontinence and pelvic organ prolapse. In prolapse, it may be used abdominally or vaginally. The use of mesh has been associated with the following adverse effects:
A risk of mesh exposure into the vagina
<2% risk for stress urinary incontinence procedures
4% risk if mesh introduced through the abdomen (robotically or laparoscopically)
10-15% risk if the mesh is placed through the vagina
New urinary symptoms – pain or difficulty urinary, leakage, urge symptoms, etc.
Recurrent prolapse requiring further surgery
Vaginal scarring, shrinkage, or narrowing causing pain
Damage to surrounding organ to include but not limited to bladder, bowel, blood vessels, and nerves
Pain with intercourse
A mesh exposure may be minor and managed effectively in the office or it may require surgery.
Scientific studies have shown that the benefits of the use of mesh may outweigh its risks in the following procedures:
Mesh sling for stress urinary incontinence.
Transabdominal mesh in sacrocolpopexy for pelvic organ prolapse
Transvaginal mesh in the anterior compartment for pelvic organ prolapse.
With advancing technology, lighter, less abrasive mesh continue to be developed.
WakeMed Urogynecology is committed to providing a balanced view of the use of surgical mesh, and giving patients options of surgery with or without the use of mesh. If you have suffered from a mesh complication, we will evaluate you and counsel you on therapeutic options.