Transvaginal mesh

Surgical mesh used in pelvic organ prolapse and stress urinary incontinence

Transvaginal mesh is a type of surgical mesh used in the treatment of pelvic organ prolapse (POP) and stress urinary incontinence (SUI) in women. It is implanted through the vagina to provide support to weakened or damaged tissue.

Uses

Transvaginal mesh is primarily used to treat two conditions:

Pelvic Organ Prolapse

Pelvic organ prolapse occurs when the muscles and tissues supporting the pelvic organs weaken, causing the organs to drop lower in the pelvis. This can affect the bladder, uterus, vagina, small bowel, and rectum. Transvaginal mesh is used to reinforce the vaginal wall and provide additional support to the pelvic organs.

Uterine prolapse illustration

Stress Urinary Incontinence

Stress urinary incontinence is the involuntary leakage of urine during activities that increase abdominal pressure, such as coughing, sneezing, or exercising. Transvaginal mesh can be used to support the urethra and bladder neck, reducing or eliminating incontinence.

Procedure

The procedure to implant transvaginal mesh is typically performed under general or regional anesthesia. The mesh is inserted through a small incision in the vaginal wall and positioned to support the affected organs. The surgery is minimally invasive and often performed on an outpatient basis.

Complications

While transvaginal mesh can be effective, it has been associated with several complications, including:

• Mesh erosion into surrounding tissues
• Infection
• Pain
• Urinary problems
• Recurrence of prolapse or incontinence
• Dyspareunia (pain during intercourse)

Due to these complications, the use of transvaginal mesh has become controversial, and regulatory agencies have issued warnings and restrictions on its use.

Regulatory Actions

In recent years, several regulatory bodies, including the U.S. Food and Drug Administration (FDA), have taken actions to address the safety concerns associated with transvaginal mesh. These actions include reclassifying the mesh as a high-risk device and requiring manufacturers to conduct post-market surveillance studies.

Alternatives

Alternatives to transvaginal mesh for treating POP and SUI include:

• Pelvic floor exercises
• Pessary devices
• Surgical repair without mesh
• Lifestyle modifications

Related pages

• Pelvic organ prolapse
• Stress urinary incontinence
• Surgical mesh
• Urogynecology

Female reproductive system illustration