Transvaginal mesh procedure and complications
Vaginal mesh repair is a common gynaecological procedure. It is most commonly used for women who have incontinence or prolapse issues. The condition can be caused by a weakness in bladder control, with childbirth being a primary cause for this weakness.
Specific risks of this procedure
- Bleeding from large blood vessels
- Infection in the operation site or urinary tract
- Injury to other organs such as the ureter(s) (tube leading from kidney to bladder) bladder or bowel
- Difficulty passing urine immediately following surgery which is usually temporary but which may require a catheter to be reinserted into the bladder, or you may be taught to pass your own catheter until you are able to pass urine without assistance
- Stress incontinence of urine following surgery. Stress incontinence is a common condition where urine leaks when you cough, sneeze or perform various other activities involving abdominal straining. In this case, whilst no problem existed before surgery, often there is an unknown weakness of the bladder which leads to this problem when surgery is carried out
- A connection (fistula) may develop between the rectum and the vagina leading to leakage of faeces through the vagina (recto – vaginal fistula)
- Pain in the perineum, which can last up to six weeks after surgery. Change in bladder and bowel habits. Pain during sexual intercourse. Pain in the perineum (area between vagina and rectum). Recurrence of the original complaint (prolapse) with the passage of time
- Narrowing or shortening of the vagina
- Increased risk in obese people of wound infection, chest infection, heart and lung complications and thrombosis
- Increased risk in smokers of wound and chest infections, heart and lung complications and thrombosis
Complications with the use of Transvaginal “mesh”
“Mesh” in the form of a permanent or semi permanent artificial support may be used in vaginal repairs to support tissues in this area that are weak.
Infection – this may require removal of the mesh.
Rejection – Loosening of the whole mesh, the mesh may partially or completely protrude through the vaginal skin causing discharge or pain to your partner during sex. This may need another operation to divide the mesh that is protruding out or to remove the entire mesh if there is infection present.
Mesh protrusion or erosion – Part of the mesh wears through a gap that develops in the vaginal skin so that it pokes out. This will usually require surgery to trim the loose portion and to close the gap in the skin.