Transvaginal mesh systems were designed to treat urinary incontinence and pelvic organ prolapse in women by providing extra support to the pelvic organs and relieving the discomforting symptoms of leakage and pressure.
While many women were relieved when such a product was released into the market, vaginal slings have been associated with a number of complications including infection and mesh erosion. In some cases, women who have been implanted with pelvic mesh implants have seen symptoms such as incontinence and abdominal fullness return or have developed signs of more serious problems.
Signs and Symptoms of Vaginal Sling Failure
The FDA released a warning in 2008 to alert women to potential vaginal sling complications, which include:
- Pain and discomfort
- Urinary and bladder problems
- Recurrence of prolapse / incontinence
- Bowel, bladder and blood vessel perforation during insertion
- Vaginal scarring
- Dyspareunia (pain during sex)
It is believed that many of these problems stem from shrinkage, contraction, or erosion of the mesh.
Mesh erosion can occur when the body “rejects” the device. In these cases, it is believed that the tissues in the pelvic region are not properly “accepting” or “incorporating” the implant. Mesh erosion can present a number of symptoms, depending on the location of the erosion. Erosion into the vagina can lead to inflammation, painful sex, and infection. Displacement of the mesh can also lead to bowel, bladder and blood vessel perforations. Many women who suffered mesh erosion have reported a feeling of something protruding from the vagina.
Internal documents from medical device manufacturers have revealed that 50% of patients implanted with transvaginal mesh products experienced shrinkage. This occurs when the mesh itself shrinks or causes the surrounding tissue to shrink as a result of inflammation or the growth of excess fibrous tissue. Improper pore size in the implants can increase the risk of shrinkage by prohibiting tissue integration. If the pores of the mesh are too small, healthy tissue cannot grow upon the implant and incorporate it successfully into the body. Injuries and symptoms associated with shrinkage include recurrence of prolapse or incontinence, discomfort and pain (including pain during sex), and vaginal scarring.
Contraction of the mesh may put increased tension on the device and, consequently, the tissue and organs to which it is attached. In some cases, contraction of the transvaginal mesh causes the “arms” of the device to narrow and exert pressure on organs.
Other general symptoms of mesh failure include:
- Urinary and bladder problems
- Lower backache
- Difficult bowel movements
A recurring feeling of fullness or pressure in the lower abdomen and recurrence of prolapsed organs may also be a sign that the condition, which the vaginal mesh intended to treat, has returned.
While the nature of these complications is well-known, the exact cause of vaginal sling problems has yet to be firmly established. It is believed that the surgical mesh interferes with the healing process, as it prevents the surrounding vaginal tissue from receiving oxygen and proper nutrients. This can lead to complications requiring further surgery.