Pelvic Organ Prolapse Surgery May Cause Lifestyle Changes in Patients

In October 2008, the FDA sent warnings to physicians that a number of serious and painful complications associated with Transvaginal Mesh had been identified in hundreds of women. These women had received the mesh in the treatment of pelvic organ prolapse, stress urinary incontinence, and a number of other problems. Early reports say erosion is the most commonly reported surgical side effect.

Studies reviewed by the FDA showed that about ten percent of women who have transvaginal mesh implanted have experienced mesh erosion within 12 months of surgery. Also more than half of these cases usually require additional surgeries to remove the mesh. In some cases, even multiple surgeries will not resolve the complication. When that occurred, the complications severely affected the victims’ quality of life.

After potentially going through several surgeries, patients may need to go through several lifestyle changes to keep healthy. First patients would need to eat at least 20 grams of dietary fiber per day to avoid constipation. Exercises that would strengthen the pelvic floor muscles would be needed to be done every day. Patients would also need to avoid or reduce caffeine intake. This is because caffeine acts as a diuretic, causing increased urination. It also advised to increase water intake and to drink eight glasses of water a day. Those who are overweight or obese would need to lose weight while other will need to maintain a healthy weight. Heavy lifting and putting pressure on women’s pelvic floor should be avoided at all times.

The FDA also says that transvaginal mesh can potentially cause other serious side effects. It is advised that you see your doctor if you are experiencing any of the following: Infection, constant pain in the pelvic area, bleeding, organ perforation, pain during sex, or urinary problems.

Vaginal Mesh Complications and Side Effects

The number of women who have been injured during or after transvaginal mesh surgery because pelvic organ prolapse have steadily increased over the years. These surgeries usually cause a drastic change in lifestyle in these women, and many of them have begun to file a vaginal mesh lawsuit, against the manufacturers of the implant. If you think that your transvaginal mesh implant is starting to cause you any problems, visit your doctor as soon as possible.

References:


http://www.providence-health-plan.com/transvaginal-mesh/

http://www.reuters.com/article/2012/01/05/us-fda-mesh-idUSTRE8041D920120105

Vaginal Mesh Erosion

Surgical mesh is medically developed to repair or support weak or damaged tissue. Surgical mesh comes from two materials, namely; absorbable synthetic materials or non-absorbable synthetic materials. Vaginal mesh are utilized in urogynecologic procedures such as Pelvic Organ Prolapse (POP) and Stress Urinary Incontinence (SUI). In surgeries for POP, the vaginal mesh is inserted to sustain the weakened vaginal wall. In SUI, it is used to reinforce the bladder neck or the urethra. From 2008 to 2010, the US Food and Drug Administration reports that the most common complications arising from surgical mesh devices are vaginal mesh erosion, pain such as dyspareunia (painful sexual intercourse), infection, bleeding and organ perforation.

Using vaginal mesh in surgeries have the likely consequence of vaginal mesh erosion. The mesh synthetic materials may break into fragments causing further damage to the tissue it supports. Swelling or inflammation and the severe pain that goes along with it may be suffered by the patient when the vaginal mesh erosion occurs. The medical condition of the woman patient will grow worse due to vaginal mesh complications, starting with terrible pain and extreme discomfort. The broad effect on the mesh damage may likely affect not only the woman herself but also her partner or her marriage.

In the previous years, the Food and Drug Administration received reports over 1,000 against surgical mesh manufacturers due to complications arising from POP and SUI surgeries. Risks for complications have not been accurately determined. Factors may be considered from the surgical mesh material, mesh size, mesh shape, surgical technique employed and overall health of the person.

Incorrect placement and poor materials are the common causes for vaginal mesh erosion. The usual manifestations of vaginal mesh erosion are pain, urinary problems, recurrence of prolapse for POP or incontinence for SUI and ultimately, a lower quality of life. To reverse the effects of vaginal mesh erosion, another surgery may be suggested which involves more expenses and more emotional pain to say the least.

Vaginal Mesh Multidistrict Lawsuit MDL spread across the country as the US FDA announced a five-fold increase in women experiencing injuries from vaginal mesh. The US FDA then changed the classification of these incidents from “moderate risk” to “high risk”. An expected surge of Vaginal Mesh Multi-District Lawsuits MDL occurred since the FDA made the warning. Between 2008 and 2010, the FDA received 1,503 reports of mesh injuries or malfunction, a fivefold increase from 2005 to 2007. These are reported cases alone and anticipation is reserved to those women patients who will surface later on.

Medical and Surgical Corrective Measures for Vaginal Mesh Erosion

In October 2008, the U.S. Food and Drug Administration issued an announcement about the danger of Trans-vaginal Mesh (TVM) implantation.   Pelvic Organ Prolapse (POP) and Stress Urinary Incontinence (SUI) are two conditions that can be treated with TVM implantation.  Because of the rising rate of negative events related to this procedure, the FDA revealed information regarding the dangerous complications of surgically implanted TVM.

Mesh erosion, sometimes also known as mesh exposure, extrusion, or protrusion, is the most usually manifested complication of TVM implantation.  This is when the mesh implanted vaginally protrudes from the vagina. This can be easily distinguished through the use of an endoscope to view the vaginal canal, or otherwise called vaginoscopy.

The common reasons for this include a surgical wound that has not fully recovered or a surgical mesh with an inferior quality.  As studies revealed, women who have low levels of estrogen in their bodies have a high risk in developing this complication.
Other predisposing factors to this complication include old age, smoking, past records of removal of the uterus, and, surgical mesh implants that don’t match the size of the vaginal wall.

Mesh erosion is introduced by primary signs. Patients ordinarily experience a sense of tightness and tugging in the vagina, sometimes with pain when sitting for a longer period of time or when engaging in sexual intercourse.  These signs initially come about one month post-surgery, according to past evidences. Other signs that can cause more harm are bleeding and unwanted discharges from the vagina, because these may lead to infection.

There are various approaches to handle mesh exposure with different degrees of erosion. For very small exposures, i.e. within 1cm range, the entire mesh need not be removed.  Surgeons normally cut off the exposed part of the vaginal mesh and letting the incision site repair on its own. On the other hand, if mesh erosion occurs during healing after the surgery, physicians usually start treating with antibiotics and vaginal estrogen cream. |But if mesh erosion happens some time after while the surgical wound is healing, doctors usually prescribe antibiotic and vaginal estrogen cream treatment. |However, when mesh erosions develop while the tissues of the surgical wound are still in the recovery stage, doctors then use antibiotic and vaginal estrogen cream  as medical care.} But if the exposed mesh is not repaired after two weeks of antibiotic and estrogen cream, the doctor will opt for surgical excision of the mesh.

For an extensive exposure, i.e. when the entire mesh is exposed, the entire vaginal mesh should be removed.   Surgeons would then suggest an abdominal mesh to treat POP and SUI instead of vaginal mesh procedure when prolapse recurs.

Careful management is needed in mesh erosions since these complications recurs most of the time. Patients who have developed a mesh erosion complication mostly had to tolerate more corrective procedures that are insufferable. On the other hand, avoiding this complication is also very possible.   It is very important for patients to be cautious not to strain themselves during the recuperation stage and keep a monthly appointment with their respective doctors to check for possible signs of complications.

References:
http://blogs.webmd.com/womens-health/2011/08/vaginal-mesh-new-fda-warnings.html
http://www.icsoffice.org/Abstracts/Publish/105/000870.pdf
http://www.empowher.com/sexual-well-being/content/vaginal-mesh-erosion-part-2?page=0,2