Transvaginal Mesh Erosion: Symptoms, Treatment and Surgery

Mesh erosion or extrusion occurs when synthetic transvaginal mesh pushes into or cuts through vaginal tissue, organs or the bladder. Erosion can occur due to the mesh breaking down, failing to bond with surrounding tissues or causing inflammation in the body.

According to an animal study published in the Journal of the Mechanical Behavior of Biomedical Materials, polypropylene mesh is less stable than previously believed. Researchers found that the mesh fibers can begin to stiffen, oxidize and degrade within just 60 days of implantation. This rapid degradation may explain why so many patients experience severe issues.

Government and medical reports, including a Federal Register Notice and a 2011 FDA safety report, show that erosion is the most common mesh-related complication after transvaginal mesh repair for pelvic organ prolapse (POP). Clinical studies have documented erosion rates ranging from 0.3% to 23% for mesh used to treat POP and stress urinary incontinence (SUI). The rates depend on a patient’s overall health, age and sexual activity.

Symptoms of transvaginal mesh erosion may include pelvic pain, bloody discharge and pain during urination or sex. Your partner may feel the mesh as a rough or sharp sensation during intercourse.

Symptoms may appear weeks, months or even years after the initial surgery. If you experience any of these, you should speak with your doctor or contact a urogynecologist.

Donna Miser told Drugwatch her mesh implant eroded into her urethra, vaginal walls and bladder. The first symptoms she experienced were severe abdominal pain, discharge and a UTI that didn’t go away. She said erosion felt like a knife-like pain in her vagina and that she also experienced discomfort during sex.

When To See a Doctor

You should see a doctor if you have any of the symptoms listed above, even if you received the implant years ago. Make sure to bring any medical records you might have from your original mesh surgery for POP or SUI.

Seek immediate care if you can’t go to the bathroom or if you experience severe pain, heavy vaginal bleeding or a fever with pelvic symptoms.

Mesh erosion can be caused by a foreign body reaction, mesh contraction, poor healing, thin tissue and surgical and lifestyle factors.

Complications can occur at any time after your initial mesh surgery, and they may take years to appear. Be sure to document your experiences and tell your doctor about any symptoms you have after your surgery.

Can Mesh Erode Into the Bladder?

Mesh can erode through the vaginal wall into the bladder. It requires surgical intervention, and it is typically diagnosed via cystoscopy (a procedure where a camera is inserted into the bladder) or a CT scan.

Doctors diagnose mesh erosion through a series of physical examinations and imaging scans.

It can be helpful to provide information on the type and brand of your mesh before diagnostic tests. You can request an operative report from the doctor, clinic or hospital where you had your original surgery. This document identifies the manufacturer and product. An attorney can also help obtain medical records.

Treatment options include conservative management for minor erosion or surgical removal for more serious erosion.

Bladder Erosion Treatment

The surgery can be more complex if the mesh has eroded into the bladder. Surgeons may use a cystoscope to see and remove mesh. They may also perform open, keyhole (laparoscopic) or reconstructive surgery, depending on the severity of damage and scarring.

After the surgery, you may have a catheter in for about three weeks to allow the bladder to heal.

Revision surgery treats complications caused by transvaginal mesh, including erosion, migration or contraction. Surgery aims to remove some or all of the mesh.

Surgery might not resolve all symptoms, and new complications may develop. However, some women feel relieved after the mesh is removed.

Can Vaginal Mesh Be Completely Removed?

Complete removal of vaginal mesh is possible, but not always achievable. It depends on the type of mesh and its location.

For example, some mesh implants feature arms and hooks that anchor the mesh to deeper pelvic tissues and ligaments. These devices can be difficult to remove, and some parts of the mesh may have to remain in the body.

What Happens if Mesh Is Not Removed?

Mesh erosion can sometimes be managed without removal, since not all women experience symptoms. However, serious erosion may worsen symptoms over time if the mesh isn’t removed.

For example, symptoms such as progressive tissue damage, chronic infections, fistula formation (abnormal connections between organs) and persistent pelvic pain can worsen. Mesh can also become more difficult to remove over time as scar tissue grows around it.

However, mesh removal may be more harmful in certain cases, depending on your overall health. It’s important to discuss treatment options with your doctor to learn what they recommend.

Recovery From Mesh Removal Surgery

Recovery from transvaginal mesh removal often takes anywhere from four to eight weeks. This depends on how extensive your surgery was, so your surgeon can provide a more personalized recovery timeline.

Any surgical incisions may be uncomfortable for up to eight weeks, but they can be managed with acetaminophen or ibuprofen. If you had mesh erode into your bladder, you may have a temporary catheter.

After four weeks, you can usually go back to regular activities if you feel well enough. Your doctor will tell you when you can return to more strenuous activities, such as running or lifting weights. Avoid vaginal intercourse for at least six weeks.

Your doctor may also recommend pelvic floor exercises or therapy to help prevent your prolapse or bladder problems from returning.

Risks of Mesh Removal Surgery

Risks of mesh removal surgery include bleeding, infection, damage to nearby organs, incomplete removal of mesh and recurrence of the original condition (incontinence or pelvic organ prolapse).

It’s important to discuss these possibilities with your provider before deciding whether the benefits outweigh the risks in your specific case.

Transvaginal mesh lawsuits allege that manufacturers, including Ethicon, Boston Scientific and C.R. Bard, knew about the risk of complications and failed to adequately warn patients and physicians.

Women who suffered mesh erosion and had surgery to remove it may be eligible to file a transvaginal mesh lawsuit. If your mesh was made by American Medical Systems (AMS) or Neomedic and you already filed a similar claim, you may not qualify.

Make sure you speak to an attorney, even if you don’t think you qualify. Drugwatch offers free assessments to determine if you have a case.