Mesh Facts and Fiction

A lot of controversy regarding surgical mesh exists, especially when surgical mesh is used to treat vaginal and/or uterine prolapse or urinary incontinence. The truth is, there are many different surgical mesh products used for many different pelvic floor disorders, and they are not all created equally. Some are considered to be “gold standards,” or “the best things out there” for prolapse or incontinence; whereas other mesh products tend to have higher complication rates and are not considered the gold standards. When it comes to surgical implants of any kind, there are always known complication rates that come along with these implants. A risk-free surgical implant does not exist.  Implants are used when traditional surgical methods do not provide optimal success rates or if there are no other means of correcting the dysfunction. For example, a total knee arthroplasty (knee replacement) is a surgical implant used very commonly. Its use provides an improvement in the quality of life of patients with knee pain that other treatment methods cannot provide. It has a known complication rate and sometimes the implant must be removed due to these complications. Mesh used in the pelvic floor for prolapse or urinary incontinence is no different. Some pelvic floor mesh products have higher complication rates than others.

History of Surgical Mesh

Prior to the use of mesh for pelvic floor disorders, the surgical options were very limited, with less than ideal long-term success rates. Mesh was incorporated into the pelvic floor surgical regime in order to provide higher long-term success rates, which it has done, to an amazing degree, in fact. Many studies have been done looking at these success rates, comparing surgical procedures with the use of mesh versus procedures without the use of mesh.  For several pelvic floor disorders, the surgical mesh procedure provides a longer lasting surgical correction, with a low complication rate. Mesh however, is not indicated for every type of pelvic floor disorder. So when discussing surgical options, ask your urogynecologist to clarify if a mesh product will be used and if so, what the associated complications are. As stated earlier, some mesh products tend to have higher complication rates; whereas other mesh products do not. Ask your surgeon to clarify what types he/she uses.