Many women wonder if it’s possible to have more than one surgery for stress incontinence and why there was a problem with the larger mesh that was initially used for incontinence and pelvic prolapse surgeries. McLeod Gynecologist Paul Chandler, MD, explains:
Here are highlights from Dr. Chandler’s comments:
The problem with repairing pelvic organ prolapse is that – like a lot of the surgeries we do – the repair won’t last forever.
If a woman has a cystocele repair – to fix a bladder that has dropped – it may last 5 years. If you get 10 years out of the repairs, you’re doing really well.
You can have it repaired the second time. And the second repair will usually work just as well as the first – sometimes better.
WHAT ABOUT MESH?
The reason that some physicians started using mesh was related to its success in repairing hernias. If they just put stitches or sutures in there, they may last a while but then quit working. So, gynecologists looked at this repair and thought it might work for women with pelvic organ prolapse, keeping them from needing repeat repairs. The mesh, made out of plastic, looks like a hair net, but a little finer.
The problem was that a lot of gynecologists, who didn’t really know what they were doing, started doing the mesh repair. And there were a lot of people hurt as a result. Once you put the mesh in, it’s very difficult to remove it. The incorrectly installed mesh can erode into organs or through the vagina.
We had all the surgeries where we put mesh between the bladder and the vagina, or the bladder and the rectum, to help hold things in place and prevent the surgery from failing.
I think mesh still has its place for certain women — those who are have bad recurrences and the traditional surgery isn’t helping.
The Food and Drug Administration eventually released a statement that warned consumers about some physicians performing the procedure incorrectly.
As a surgeon, I had pretty good success using mesh, but following the FDA warning (and all the lawyers on the TV) it became difficult to convince patients to use the mesh.
The problem arose when the tissue gets thin, the mesh can actually come through the tissue. And you can feel the mesh through the wall of the vagina.
There were unhappy men who tried to have intercourse with their wives and the mesh eroding through the vagina caused the men pain.
I think that many of the doctors who had problems with the mesh procedure were not trained well enough to do it and, as a result, women were hurt from it.