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Urology

Vaginal Mesh Removal – The Good, The Bad and The Ugly

Dr. Joe Pazona

The word “mesh” is not associated with good vibes these days. It seems like every time we turn on the TV, there’s an infomercial from a law firm with some man screaming at us:

“Did you have vaginal mesh surgery? Are you suffering with terrible complications? Call us NOW and we will sue your doctor together!”

Despite what you’re led to believe, not all vaginal mesh is bad. If you have had vaginal mesh surgery it doesn’t mean something terrible is going to happen to you. Most women who have vaginal mesh placement do not in fact require a removal.

If you are wondering if you need vaginal mesh removal, the symptoms of a vaginal mesh complication are typically not subtle. Bleeding, pain, and infections tend to be persistent and should lead to a thorough investigation.

If you are dealing with complications and are considering vaginal mesh removal, then we are here to help. At VirtuCare our board-certified urologists will provide you with accurate, up-to-date information from the comfort of your home so you can get the care you deserve. 

Vaginal mesh removal doesn’t have to be experienced alone.

What is vaginal mesh?

Vaginal mesh refers typically to synthetic, non-absorbable surgical material that is used in surgery to treat stress urinary incontinence and pelvic prolapse. It is typically placed through a vaginal incision in between the layers of the vaginal wall and the adjacent organ (bladder and urethra above, rectum below).

The vaginal mesh provides support to weakened tissues that can no longer hold the pelvic organs in place. It looks very similar to the mesh lining of men’s bathing suits. The material is pliable, strong and allows the body’s tissues to grow in between the holes in the matrix.

What are the symptoms of pelvic mesh complications requiring vaginal mesh removal?

The vaginal wall is approximately 5-10 mm thick. Therefore, mesh that is placed 1-2 mm too deep or too shallow can lead to a pelvic mesh complication. Given such a small margin for error, it’s no surprise that pelvic mesh complications can occur.

Pelvic mesh complications and their symptoms include:

  • Mesh extrusion into the vagina (vaginal pain or bleeding, penile pain during intercourse)
  • Mesh erosion into the bladder/urethra (bladder infections, burning with urination)
  • Bladder outlet obstruction (difficulties urinating)
  • Pelvic pain
  • Infection

Can vaginal mesh be removed?

Vaginal mesh can be removed with another surgery. Vaginal mesh removal should be considered if you are suffering with any of the previously mentioned symptoms due to a pelvic mesh complication. 

Vaginal mesh removal may not be necessary if you have a small vaginal extrusion, are not sexually active and don’t have any pain. If you have new onset pelvic or back pain years after a vaginal mesh surgery, and there’s no evidence of exposed mesh on an exam, then it’s unlikely the mesh is the cause of your pain.

How long does vaginal mesh removal surgery take? How long is recovery for vaginal mesh removal surgery?

The difficulty and length of vaginal mesh removal surgery can vary depending upon how long it has been since the original vaginal mesh placement.

Vaginal mesh removal in the first week or two after surgery should be relatively quick. The most common reasons for vaginal mesh removal early after surgery include acute pain, difficulty urinating or infection. Recovery should be a few weeks and be limited to pelvic pain and minor bleeding.

Vaginal mesh erosions and extrusions tend to occur later in the recovery process. These surgeries may be quite complex depending on the size and extent of the exposed mesh. Involvement of the bladder or urethra and presence of a fistula (abnormal connection between the vagina and urinary tract) can take several hours to repair. Recovery may be 6-8 weeks or longer.

On the other hand, small vaginal mesh extrusions may take less than 30 minutes to perform mesh removal. Recovery is typically a couple weeks.

How do I find the right doctor for vaginal mesh removal?

This is one of those situations where finding the right doctor is imperative. Vaginal mesh removal surgery is complex and not commonly performed by most urologists. Finding a female urology specialist with extensive surgical experience in vaginal mesh removal is necessary.

How do you find the right specialist? Start with an online search for urogynecologists in your geographic area. If you’re lucky, then you’ll find a specialist with experience and positive online reviews.

Another option is a telemedicine consultation today. Here at VirtuCare we haven’t yet mastered in-home remote surgery, but we have mastered compassionate care with expert options.

Considering vaginal mesh removal is a big deal. With a VirtuCare specialist on your side, we can provide guidance and help you find the best surgeon for vaginal mesh removal.

Click here to request a telemedicine consultation with a VirtuCare expert today. 

ABOUT THE AUTHOR

Dr. Joe Pazona

Dr. Joseph Pazona is the founder and President of VirtuCare, a telemedicine solution for connecting patients with physician experts.
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