What is vaginal mesh?

Answer 1

Surgeons first used surgical mesh in the 1950s, to treat abdominal hernias. In the 1970s, by cutting that same type of surgical mesh into a different shape, doctors began using it to treat female Stress Urinary Incontinence (SUI) and Pelvic Organ Prolapse (POP)-a condition in which a woman's bladder, rectum, bowels and/or reproductive organs slip down into her vaginal opening.

In 2001, the U.S. Food and Drug Administration (FDA) reviewed the first surgical mesh specifically indicated for the treatment of POP and found it substantially equivalent to surgical mesh indicated for hernia repair. The FDA issued this finding without clinical data. Since then, the agency has cleared without clinical data many other mesh products indicated for the treatment of POP.

Mesh Products Are Available In Both Biologic And Synthetic Form

The vaginal mesh products on the market fall into the following four categories:

• non-absorbable synthetic (e.g., polypropylene or polyester),

• absorbable synthetic (e.g., poly(lactic-co-glycolic acid) or poly(caprolactone)),

• biologic (e.g., acellular collagen derived from bovine or porcine sources), and

• composite (i.e., a combination of any of the previous three categories).

Using Vaginal Mesh To Treat POP and SUI

"In general, mesh products for vaginal POP repair are configured to match the anatomical defect they are designed to correct," according to the FDA executive summary titled "Surgical Mesh for Treatment of Women With Pelvic Organ Prolapse and Stress Urinary Incontinence." When doctors use mesh to treat SUI, they create a hammock of support under the urethra.

When doctors first started using mesh to treat POP and SUI, they were doing so via incisions in the patient's abdomen. By the 1990s, doctors began treating SUI and POP by inserting mesh transvaginally (i.e., through the vagina). Many of the problems vaginal mesh recipients are currently suffering are due to the transvaginal placement of the mesh products.