A recent study, published by BJOG: An International Journal of Obstetrics and Gynaecology on 28 May 2021, has shown that only 33% of women suffering from pain alone after vaginal mesh surgery were pain free following excision and 58.3% of women who underwent mesh removal surgery as a result of pain and mesh exposure reported no difference in symptoms following the removal.
Since it was banned in the UK in 2019, vaginal mesh is not approved for use in prolapse or urinary incontinence surgery unless in extreme circumstances. Many women who have undergone vaginal mesh surgery have subsequently suffered from complications, including severe pelvic and lower abdomen pain, dyspareunia, worsening urinary symptoms, mesh erosion and mesh extrusion. These complications are life-changing and can require several forms of management.
Some urogynaecologists specialising in vaginal mesh surgery are supportive of removing all or most of the mesh, advising patients that their symptoms should improve afterwards. However, for some time now, the success of vaginal mesh removal has been queried in the urogynacological world.
Liz Adams, an expert consultant urogynaecologist who works closely with the vaginal mesh team at Penningtons Manches Cooper, has given her opinion on this latest study: “Some 80% of women we treated with vaginal meshes were very satisfied at the time as they mainly had an end-stage recurrent prolapse. However, erosion, the rate of pain and dyspareunia have been increasingly recognised as issues as a result of the mesh, affecting around 20% of all vaginal mesh patients. These meshes are inert and not designed to be removed as they become embedded in the vaginal tissues within 48 hours.
“There is a real danger of women being inappropriately counselled about the likely outcome of major mesh removal surgery, especially where their initial symptoms may be relatively minor or non-existent. This is something I have seen in my medico-legal practice. Patients can particularly end up with increased pain, ongoing exposure of mesh or disabling new symptoms related to the very major surgery that is needed to remove a mesh, which by its nature is embedded into tissue.
“This paper indicates that the cure may often be less beneficial or worse than the original symptoms and mesh removal centres should not carry out these procedures without a strong reason, MDT and outcome monitoring.”
If you have experienced issues following vaginal mesh surgery or removal surgery, a member of our specialist team can be available for a free, no obligation discussion to assess your options.