Sunday, March 11, 2012

Transvaginal Mesh Complications and Corrective Procedures: The Long Road to Recovery

In the past few years more and more women are coming forward to report complications—some of them quite severe—which resulted from surgeries involving the use of transvaginal mesh implants. Mesh has been implemented in surgeries as far back as the 1950’s, when it was used in hernia repair over the more traditional suture repair, with excellent results. In fact, when the mesh procedure was used there was a significantly lower recurrence of the hernias.

Doctors soon began using the mesh in other applications such as the repair of pelvic organ prolapse and stress incontinence, simply cutting it to the size needed. Unfortunately, due perhaps to the difference in elasticity between the abdominal area and pelvic area, many women have reported medical issues following their mesh surgery including severe infections, pain in the pelvic region, adhesions, mesh erosion, chronic urinary tract infections, bowel and bladder injuries, painful scarring, painful sexual intercourse, and even death in a few tragic cases. Correcting these injuries can require one or more surgeries performed by a surgeon with training and experience in mesh injury surgeries.

Mesh Extrusion or Erosion

The most common complication of the transvaginal mesh placement occurs when the mesh breaks through the incision or the vaginal lining, resulting in bleeding, excess vaginal discharge, recurring urinary tract infections, drainage of urine into the vagina and can even cause pain to a male partner during intercourse. The exposed mesh as well as the surrounding injured vaginal tissue must be removed followed by pelvic reconstructive surgery. Some of the most highly skilled surgeons in the country are implementing a new surgical instrument known as the Plasma Blade in favor of the more traditional scalpel or cauterization devices, however it can be difficult to find a surgeon trained in using this innovative instrument.

If the mesh has eroded into the bladder, it must first be removed, then the damage to the bladder and the vaginal wall must be repaired, usually through the abdomen with a fairly large incision and a relatively long recovery time. Depending on the extent of the erosion some doctors perform the procedure laparoscopically, which is typically an outpatient surgery done through a mini-incision in the belly button. Performing the repairs in this manner is considered an advanced procedure and should only be attempted by a surgeon who is highly experienced in the technique as well as the necessary pelvic reconstruction. Should the mesh have eroded into the bowel or rectum it is considered a very serious complication.

Chronic Pain

Pain which results from the transvaginal mesh implant can be very difficult to treat, and is typically a result of the placement of the mesh rather than the specific material of the mesh. If the mesh implant is too small or requires attachment near the pudendal nerve, then there may be moderate to severe pain for the first two months following the surgery and in some cases for much longer. If the pain persists longer than two months or if it radiates down the leg then surgical intervention will likely be required to alleviate the pain. Back pain and lower abdominal pain are named by the FDA as complications of the transvaginal mesh implant. If the pain is related to tension, or the mesh being too tight and pulling on the surrounding ligaments and muscles, the surgeon may have to open up the original incision, cutting the higher attachment points of the mesh implant. If tension is not the cause of the pain, treatment can be more difficult and could include injections or surgical release of the pudendal nerve—a highly skilled surgery which is currently performed by only a few surgeons across the nation.

Different Types of Mesh

Studies show that a Type I mesh tends to be tolerated better, resulting in the fewest complications when used in POP and SUI surgeries, and infections using this type of mesh are rare. Type I meshes are monofilament and somewhat porous, which allows the body’s bacteria-fighting cells to have unimpeded access to the mesh implant. Mesh made of Gore-tex has been shown to cause the highest rates of infection and erosion therefore is being used less and less often in the transvaginal application.

Women Suffering from Mesh Complications

Prior to the FDA issuance of warnings regarding the potential complications of the mesh implant, many women suffered in silence, too embarrassed to speak out. Over 4,000 women have come forward—with many more expected—to speak out about the serious symptoms they have suffered as a result of their transvaginal mesh implant. Some women have undergone multiple surgeries in an attempt to prevent further pain and suffering. Not only have these women had to have the mesh from their original surgeries removed, but have then required further corrective surgeries to repair the damage done by the mesh. If you or a loved one has suffered harm from the mesh implant it’s important that you first speak with an experienced and reputable physician then find a highly qualified attorney to discuss your potential case with.

Author: Sullo & Sullo Attorneys

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