Transvaginal Mesh Terminology

Pelvic floor:

The National Institute of Health defines the term “pelvic floor” as a group of muscles that form a sling or hammock across the opening of a woman’s pelvis.  These muscles, together with their surrounding tissues, keep all of the pelvic organs in place so that the organs can function correctly.

Prolapse:

According to the Mayo Clinic, when the muscles and ligaments supporting a woman’s pelvic organs weaken, the pelvic organs can slip out of place. This is known as Prolapse.

Pelvic Organ Prolapse:

Harvard Medical School defines POP as follows:  Weakened pelvic floor muscles cause the fascia and ligaments to carry the entire weight of the pelvis. Sometimes these weaken causing the pelvic organs then to drop or sometimes even protrude into the vaginal wall.

Stress Urinary Incontinence:

Stress urinary incontinence (SUI) happens when the pelvic floor muscles weaken and/or a deficient urethral sphincter exists.  This causes the bladder to leak when exercising, coughing, sneezing, or even laughing according to the National Association For Continence.

Transvaginal Sling:

Cleveland Clinic states the vaginal sling procedure creates a support hammock which encourages the prevention of the urethra opening when coughing, sneezing, or laughing. A piece of material is placed under the urethra during this procedure.

Transvaginal Mesh Erosion

The FDA found that mesh erosion was the most common and reported transvaginal mesh complication. Over the past three years, the FDA has received over 1,000 reports from nine surgical mesh manufacturers of complications that were associated with surgical mesh devices used to repair POP and SUI. These mesh devices are usually placed transvaginally utilizing tools for this minimally invasive placement.

The most frequent complications included erosion through vaginal epithelium, infection, pain, urinary problems, and recurrence of prolapse and/or incontinence. There were also reports of bowel, bladder, and blood vessel perforation during insertion. In some cases, vaginal scarring and mesh erosion led to a significant decrease in patient quality of life due to discomfort and pain, including dyspareunia.

Transvaginal Mesh Contraction or Shrinkage

Transvaginal mesh contraction is a new risk that the FDA has identified. It has been reported in adverse event reports to the FDA only since 2008. It is related to vaginal shortening and vaginal tightening as well as pain – FDA Alert.  The FDA states vaginal mesh contraction is a serious complication after prolapse repair with armed polypropylene mesh that is associated with substantial morbidity, frequently requiring surgical intervention.

Additional Transvaginal Mesh Information and Helpful Links

For more information please contact Bernheim & Dolinsky, L.L.C. at 1-800-474-4089 or contact us online.

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