Transvaginal mesh has been used across Europe, Australia, and the U.S. since the early 2000s, and for a good reason. Mesh implants take no more than 30 minutes, are performed using keyhole surgery, and patients go home the same day.ย
However, transvaginal mesh has been under fire over the past decade for causing medical complications among women. Bleeding, scarring, infection, and severe discomfort are reported complications from failed transvaginal mesh devices.ย
In the U.S., the FDA ordered surgical mesh product manufacturers to stop selling and distributing their products in 2019.ย
How should you manage stress incontinence or pelvic organ prolapse, then? The good news is that there are several alternatives to transvaginal mesh, and this guide discusses that.ย
Transvaginal Mesh and the Controversy Surrounding It
Transvaginal mesh is a net-like medical device that is used to treat urinary incontinence and pelvic organ prolapse among female patients. This surgical mesh is inserted transvaginally to repair weakened or damaged pelvic muscle walls and to support the bladder or urethra.ย
Early clinical tests demonstrated outstanding efficacy. Many surgeons opted for transvaginal mesh implants over traditional open-surgery procedures, which required a lot of time, had a longer recovery time for patients, and had their own set of complications.ย
But, in recent years, a growing body of evidence demonstrated that the complication rates were high for transvaginal mesh implants, and the efficacy was low.ย
New research published in the International Urogynecology Journal revealed that mesh complications have altered their lives irreversibly, causing chronic pain. Transvaginal mesh has also impacted their quality of life. Physical pain includes pelvic pain, dyspareunia (painful intercourse), and mesh exposure or erosion.ย
Various mesh manufacturers are now facing lawsuits from thousands of women affected by these implants. Women in the transvaginal mesh lawsuit are suing manufacturers on grounds of negligence, defective design of the product, and failing to warn them of the risks associated with the use of the surgical device.ย
Lawsuits are filed against C.R. Bard, Ethicon, Coloplast, American Medical Systems, and Boston Scientific.ย
Currently, ObTape, another brand of transvaginal mesh, is facing multidistrict litigation, points out TruLaw. Multidistrict litigation for ObTape primarily focuses on claims that the manufacturer, despite knowing about the possible complications associated with the use of its mesh, failed to warn patients or healthcare providers.ย
About 95% of cases have been settled or resolved, but lawyers are still accepting cases for potential trial or settlement.ย
Alternatives to the Risky Transvaginal Mesh
A transvaginal mesh implant isnโt the only surgical method to treat urinary incontinence or pelvic organ prolapse. There are several ways to strengthen weakened or damaged internal tissue. Weโll discuss a few common ones in this section:ย
1. Vaginal Pessary
For centuries, vaginal pessaries have been used as a conservative treatment for pelvic organ prolapse. But, more recently, they are being used to manage stress urinary incontinence.ย
A vaginal pessary, one of the oldest medical devices, is a ring-like tool that goes into the vagina. Once in place, this soft device provides support to the pelvic organs.
Different types of vaginal pessaries are available on the market. Some have been specifically designed for the treatment of stress urinary incontinence. The Uresta device, incontinence ring with support, incontinence ring pessary, and incontinence dish are used to treat the loss of bladder control. Dish pessaries and incontinence rings are typically made of silicone.ย
You should always get a vaginal pessary fitted by a healthcare professional. Thatโs because many women require multiple fittings to achieve comfort. Also, before the pessary is fitted, a vaginal exam is conducted to determine which type will be the best.ย
Significant improvement in bladder and bowel function and prolapse symptoms is noticed among women who wear a vaginal pessary. However, irritation and erosion of the skin inside the vagina can occur. But thereโs nothing to worry about. Frequent removal of the pessary or vaginal estrogen will resolve the problem.
2. Absorbent Products
Absorbent items help manage urinary incontinence, which is why they are an excellent alternative to transvaginal mesh. These are usually classified into two categories based on the severity of incontinenceโ light and moderate to heavy. Almost all absorbent items are available in single-use and reusable variants.ย
Inserts work well for both light and moderate to heavy incontinence. Irrespective of whether you choose a washable or reusable variant, you will have to wear them with close-fitting underwear.ย
Many women choose sanitary pads in place of insert pads. Easy availability and affordability make them choose the former over the latter. You can do so, but remember they donโt absorb as much urine as insert pads.ย
Wearing adult diapers can help avoid the discomfort or embarrassment of bladder leaks. Adult diapers are like baby diapers, featuring fasteners on the side. People with heavy incontinence benefit from adult diapers. Even those who have trouble walking or standing will find diapers convenient for managing urinary incontinence.ย
Reusable underpants are great for people with light bladder weakness. These pants have in-built pads that absorb urine. You can wear these pants as often as you want because they are washable.ย
3. Kegel Exercises
Accidental leaks occur due to weak pelvic floor muscles.ย
You can control urinary incontinence by doing kegel exercises daily. Kegel exercises prevent bladder leakage and other problems by strengthening the pelvic floor muscles. These muscles support the rectum, small intestine, bladder, and the uterus.ย
To get started with Kegels, you need to identify your pelvic floor muscles. Once you identify them, lie down and tighten those muscles as much as you can. Hold the muscles for about three to five seconds. Then, release the muscles, rest for a few seconds, and repeat the procedure.ย
The bottom line is women can experience complications such as vaginal scarring and chronic pain with transvaginal mesh implants. Rarely do mesh complications occur right after surgery. Women experience them years after the surgery, which makes treatment difficult.ย
Before you run to a doctor for a transvaginal mesh implant for treating stress incontinence or pelvic organ prolapse, consider non-surgical options.ย
Vaginal pessaries and absorbent items such as diapers and insert pads are great when it comes to managing incontinence. But strengthening your pelvic floor muscles will help control incontinence. Therefore, do kegel exercises daily.ย
Making certain lifestyle changes, such as eating healthy food and exercising or swimming regularly, can improve urinary incontinence.ย
