Problems following previous surgery (including removal of mesh)

Vaginal Mesh with Dr. Gonzalez - English

Transvaginal mesh is a net-like implant usually made of polypropylene. The term “transvaginal” refers to the type of surgical technique used to implant the mesh – through the vagina. This type of surgical mesh was created to permanently fix pelvic organ prolapse (POP) and stress urinary incontinence (SUI). As the usage of these products became more common, manufacturers began selling their mesh products in “kits.” These kits are prepackaged with mesh, special tools and instructions to help doctors implant it. Doctors can surgically place mesh transvaginally or abdominally, but inserting the mesh through the vagina is quicker, easier and less invasive.

In 2008 and again in 2011 the FDA released a Public Health Safety Notification warning about the complications of transvaginal mesh and stated that complications are not rare. Abdominally placed mesh for POP had lower risks of complications.

Mesh-related complications include mesh exposure into the vagina or even the bladder or bowel, infection, granuloma, pain syndrome, painful intercourse (dyspareunia), and voiding problems. Pelvic abscesses and rectovaginal or vesicovaginal fistula are also reported. These complications occur in approximately 10% of patients and may lead to a significant decrease in quality of life. Complications can be treated noninvasively in selected cases. However, with more severe mesh-related complications, partial or complete mesh revision may be unavoidable. Because synthetic surgical mesh was designed to stay in the body indefinitely, removal of the mesh is extremely difficult. Once mesh is removed, repair of the underlying tissues may be necessary to help restore normal function.

Unfortunately, revision surgery doesn’t guarantee that all symptoms will disappear. It is sometimes the case that the mesh itself is not the problem, but rather another untreated problem persists that is contributing to the symptoms. Specialists in pelvic reconstruction are trained in handling these concurrent problems.

Here at Houston Metro Urology, we have highly trained and experienced doctors that are able to successfully perform these complicated mesh revision surgeries. We are prepared to use the least invasive approaches to repair and restore normal pelvic function.