According to a just-published FDA report (2011), the most common problems reported when mesh was used for repair of prolapse were:
- Erosion or protrusion of the mesh from the soft tissues
- Pain, including pain with intercourse
- Infections in the area of the mesh
- Urinary tract problems
- Bleeding from the mesh site
- Damage to nearby organs
According to one of the largest analyses of almost 12,000 women, about 10% of women experienced mesh erosion within a year after surgery. This figure includes both synthetic mesh and biologic types (Abed, 2011). Individual studies have found rates that were as low as 1.2 %, as in a group of 446 women derived from a private uro-gynecology clinic (Stephanian, 2008).
Some risk factors have been described which might predispose a woman to have mesh erode into vaginal tissues. Among 322 women who had a 24 month follow up after mesh repair for POP, having a hysterectomy at the time of POP surgery, and being a smoker increased risk for mesh problems (Cundiff, 2008). When the mesh was placed through a vaginal approach (as opposed to an abdominal incision) there were more mesh complications (Visco, 2001). Other risks may include: increasing age, low estrogen levels, size of mesh implant, and variations in surgical technique (Mistrangelo, 2007). Keeping one’s uterus and use of a mesh just for rectocele repair seemed to decrease risk (Caquant, 2008).
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