For the last couple of years, we’ve heard an outcry from women complaining about the unbearable pain caused by their vaginal mesh implants.
mesh implants are used to treat female patients suffering from stress
incontinence or pelvic organ prolapse. These conditions are especially
common in women as a result of pregnancy and childbirth.
The vaginal mesh
is a net-like material made up of either polypropylene, animal tissue
or a combination of both. The mesh is inserted via the abdomen or the
vagina. A transvaginal insertion of the mesh is viewed by
urogynaecologist as less invasive than a transabdominal insertion.
net-like structure of the mesh allows the tissue to grow through the
mesh pores to strengthen and provide support to the affected organs.
For patients suffering from stress incontinence, doctors use this mesh
to create a bladder sling. The sling acts like a type of hammock,
supporting both the bladder and the urethra.
The risk percentage
for surgical mesh procedures is lower in patients with stress
incontinence than those with pelvic organ prolapse. The bladder sling
helps to keep the urethra closed and thereby preventing leakages. When
successful, this procedure has the capability to improve the quality of
life of those who had suffered from stress incontinence.
However, thousands of women
who have undergone the procedure have reported complications regarding
the mesh. These complications include burning sensations in the pelvic
area and debilitating pain. In some cases, this pain has prevented some
patients from returning to work, in others it has made a simple task
like walking a considerable struggle. The material of the mesh also
places females at risk of organ perforation.
The quality of life of many patients has significantly decreased after the procedure.
Like Stella Channing who told Woman and Home
that “You spend your day thinking that the best way to get through the
day would be to drug yourself up. You take pain killers and then take
sleeping tablets, so that you can try and escape the raw burning pain
and the ongoing nerve pain that makes you writhe in agony.”
The English National Health Services has reported that nearly 10% of women who have had the mesh inserted have experienced some kind of complication.
In 2017, a vaginal mesh complication cost the life of Chrissy Brajcic.
Brajcic, a Canadian woman had her mesh removed after it caused nerve
damage in her pelvic area. However, after several urinary tract
infections, Brajcic returned to hospital where medical staff discovered
that the area where the mesh had been inserted turned septic.
In December 2017, New Zealand became the first country to ban the use of surgical mesh
in organ prolapse and incontinence procedures. Australia issued a ban
on the use of surgical mesh for the treatment of organ prolapse in
According to the Independent
newspaper, the NHS England accepted the recommendation to temporarily
ban surgical mesh procedures in England. The ban extends till March
2019, during which the product will be placed under medical review. In
the United States, the Food and Drug Administration has categorised the
insertion of surgical mesh as a high-risk procedure.
South African perspective
Two South African urogynaecologists,
however, are arguing in favour of the bladder sling surgery. Dr Stephen
Jefferey, who is the head of the Urogynaecology Unit at the University
of Cape Town and his practice partner, Dr Pieter Kruger, who is the
urogynaecology fellowship director at Groote Schuur Hospital, argue that
patients are not getting the full story when it comes to surgical mesh
or bladder slings.
“Patients need to understand that there are two
very different mesh products. The sling is very narrow and is a safe
and effective treatment for many cases of incontinence,” said Jefferey
in a Medical Brief press release. “The complications of mesh surgery are
well known and should be discussed with patients. The common
complications are mesh erosion and chronic pain and that can vary
between 1-10%. A lot of the complications related to mesh surgery can be
avoided by training sub-specialist in uro-gynaecology and choosing the
correct procedure for the individual patient,” explains Kruger in the
Surgical mesh operations, like most medical
procedures carry risks. However, according to several investigations,
there's not enough medical research to back the use of surgical mesh in the treatment of stress incontinence or pelvic organ prolapse.
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