Transvaginal mesh surgery is a common solution for moderate to severe cases of pelvic organ prolapse. However, vaginal mesh products have been linked to serious health complications in thousands of cases.

The vaginal mesh material is now considered so risky that the U.S. Food and Drug Administration (FDA) has issued multiple warnings to the public, and major medical manufacturers have pulled some of their transvaginal mesh products from the market. Now, a recent study concludes that pelvic floor exercises are a viable non-surgical alternative to risky transvaginal mesh surgery.

What Is Pelvic Organ Prolapse?

Pelvic organ prolapse occurs when organs sag or fall into the vaginal canal because of weak pelvic muscles. Transvaginal mesh serves as a hammock beneath the organs to hold them up. Usually, the bladder, uterus, rectum or bowel is involved in the prolapse.

Depending on the organs involved, surgeons may place the piece of mesh on the front, back or top wall of the vagina. The type of mesh used also varies in shape and size. This type of surgery is usually performed transvaginally. In fact, three out of four surgeries to treat pelvic organ prolapse with mesh were done transvaginally in 2010.

Transvaginal Mesh Complications

On July 13, 2011, the FDA issued a safety communication and update, intending to inform patients and health care providers that “serious complications associated with surgical mesh for transvaginal repair of pelvic organ prolapse are not rare.”

Although transvaginal mesh surgery is simpler and less invasive than more traditional treatments for pelvic organ prolapse, it also carries a higher complication rate. In 2011, the FDA reported that it had received 4,000 reports of transvaginal mesh complications in the previous six years.

The agency previously reported in 2008 that complications from transvaginal mesh used for surgical treatment of pelvic organ prolapse were rare, but in 2011 it updated its statement and warned patients and doctors that they are not rare.

Severe complications like mesh erosion and organ perforation require surgery to fix. This surgery is referred to as revision surgery. However, because synthetic surgical mesh was designed to stay in the body indefinitely, removal of the mesh is extremely difficult. The blood vessels and tissues grow around the mesh, requiring doctors to remove it in pieces, one surgery at a time.

Study Indicates Alternative Treatment For Pelvic Organ Prolapse

In a recent study published in December in the British Medical Journal, researchers indicate that a potential alternative to transvaginal mesh surgery is to train pelvic muscles to become stronger.

The study consisted of women 55 and older who suffered from mild pelvic organ prolapse. Researchers had half of the study group perform pelvic floor exercises while the other half did nothing for three months. The study reports that 57 percent of the women in the training group improved the strength of their pelvic muscles, while those in the waiting group only improved by 13 percent. However, more studies are needed to investigate the long-term effects of pelvic floor exercises as an alternative therapy to transvaginal mesh surgery.

Transvaginal Mesh Lawsuits

While vaginal mesh products were created to help women suffering from pelvic organ prolapse, not all of them are safe and reliable. The design and manufacturer-recommended implantation technique of some of these transvaginal mesh products reportedly contributed to serious complications such as infection, erosion of the vaginal tissues and organ perforation.

Reports of complications came too late for hundreds of thousands of women who already had pelvic mesh implanted. Nearly 40,000 vaginal mesh lawsuits filed by women injured by mesh implants are pending in the U.S. District Court for the Southern District of West Virginia. Additional transvaginal mesh lawsuits are pending in state courts.