This piece was originally published June 9, 2016.
Abbas Shobeiri, MD, is board certified in obstetrics & gynecology and female pelvic medicine & reconstructive surgery (urogynecology). He is vice-chair of gynecologic subspecialties at Virginia Commonwealth University Inova Fairfax Campus. He has a special interest in women’s pelvic floor disorders. Read Dr. Shobeiri’s profile.
Transvaginal Mesh Kits: High-Risk Devices
Over the past several years, the U.S. Food and Drug Administration (FDA) has received more than 1,000 reports of serious complications related to transvaginal mesh kits, devices implanted through the vagina to treat prolapse of the bladder, rectum and uterus. Thousands of women have filed lawsuits against mesh manufacturers, and earlier this year, the FDA reclassified the mesh as a high-risk device.
While we don’t have exact numbers, it’s estimated that as many as hundreds of thousands of women received transvaginal mesh implants before these problems came to light. Now, many are experiencing problems such as erosion of the mesh material, pain and incontinence. Fortunately, we can help them.
Pelvic Organ Prolapse and Vaginal Mesh
Surgical meshes have been used to support weak or damaged tissue in a variety of conditions, such as abdominal hernia. In many cases, they are safe and effective. The problematic meshes are those placed through the vagina (transvaginally) to treat pelvic organ prolapse (POP).
POP is a condition in which the tissues and muscles of the pelvic floor cannot support the pelvic organs. The condition can develop after childbirth, menopause or hysterectomy.
As we now realize, mesh kits placed through the vagina to treat POP can gradually move through the vaginal wall and sometimes into surrounding organs. This can cause urinary and bowel problems, bleeding, infection and pain. Some women who received the mesh started having problems shortly after it was implanted. For others, the debilitating symptoms don’t arise until years later.
Spotting Problem Areas With Ultrasound
Inova Fairfax Hospital is one of a handful of locations in the U.S. where we’re using high-definition 3D ultrasound technology to identify and treat vaginal mesh complications. With ultrasound, we can see exactly where the mesh is located and where it’s causing problems.
The ultrasound images also guide my colleagues and I as we design surgical interventions to treat the debilitating effects of the mesh.
Some of my patients have already had multiple surgeries to remove vaginal mesh, yet they still experience pain and other complications. With our transvaginal 3D ultrasound imaging, we can figure out what’s causing the symptoms. Sometimes, small amounts of mesh are left behind after surgeries that were performed to remove it. In other cases, we identify nerves that have been damaged by the mesh.
We welcome women to come to us for treatment even if they’ve previously been treated for mesh complications. We’re able to plan treatments to alleviate problems and restore the patient’s functioning and quality of life.
High-definition ultrasound has become an extremely valuable tool for treating vaginal mesh complications. But the sooner we treat complications, the better the outcome. I want to get the word out so that afflicted women don’t have to suffer.