Have you heard enough about vaginal mesh and slings?
Unfortunately, most of the information on television commercials and on the internet is not very accurate. My goal in this article is to set the record straight and explain the pros and cons of procedures using mesh. Like any surgical procedure, complications do occur, but when used carefully, in the right patients and with proper training and experience, both slings and mesh are very valuable tools. They have improved the lives of many women while causing relatively few complications compared with other operations.
So why do we ever use mesh in surgery?
To answer that question, we need to review a few stats. Women have, on average, a 7-10% chance of needing pelvic floor surgery at some point in their lives. The problem is, 30% of those women will need that surgery repeated due to eventual failure of the original operation. Every subsequent surgery carries an even higher risk of failure and of complications. That’s where mesh comes in. Using mesh either abdominally, laparoscopically, robotically, or vaginally will reduce the risk of failure of an initial surgery, and thus reduce the risk of needing a repeat surgery, and if used for a repeat surgery, will improve the chances of long-term success. So, to summarize, not all patients need mesh, but used properly, it can reduce the risk of reoperation for surgical failures and has a very low risk of serious complications. The vast majority of patients report significant improvement in quality-of-life and sexual function.
Finally, a sling procedure for stress urinary incontinence (leaking with coughing, sneezing, or laughing) should be distinguished from a mesh procedure for pelvic prolapse. The two common types of outpatient slings have the best combination of safety and effectiveness in treating stress incontinence of any incontinence surgery ever invented. The incidence of serious complications from these very narrow strips of mesh-like material is extremely low when the surgery is performed for the right reasons by surgeons with the proper training and experience.
The bottom line is this: Women with bothersome pelvic floor disorders such as prolapse and urine leakage should be reassured that safe and effective treatment is available, with or without mesh.
Gynecology & Urogynecology, P.C.
Edward S. Levy, MD
816 S. Kirkwood Road, Suite 100.
Kirkwood, MO 63122