If you’ve had problems with your pelvic floor, you may have had surgical mesh inserted to provide extra support. Your pelvic floor is a part of your body that helps hold your female reproductive organs, bladder and rectum in place. When it’s weak or damaged, you might notice urinary incontinence, trouble controlling your bowel movements, pain or pressure in your pelvis or problems with sexual intercourse.
Many women have had mesh inserted to support the pelvic floor and alleviate their symptoms. “Most people with vaginal mesh have a good outcome and do not require mesh removal,” said Christian Twiss, MD, a urogynecologist with Banner - University Medicine.
Why you might need your vaginal mesh removed
Sometimes, women have problems with the surgical mesh. The mesh may shift into the vagina, bladder or bowel. Or women may have persistent pain or pain during sexual intercourse. “In the small portion of people who have a mesh problem, it can be quite severe and debilitating,” Dr. Twiss said.
What happens if you need your vaginal mesh removed
If small amounts of vaginal mesh need to be removed, it’s a relatively simple surgery. It can often be done as an outpatient procedure in a doctor’s office with a local anesthetic or as a same-day surgery with a light, general anesthetic.
But removing all the mesh, or large portions of it, is complicated. Mesh insertion is intended to be permanent, so tissue often grows into and around it. That makes removing it difficult since there’s a risk of damaging the tissue and surrounding organs. The type of mesh that was initially inserted can also affect how much mesh can be removed. “These procedures should be performed by surgeons experienced in vaginal mesh removal,” Dr. Twiss said.
This type of procedure needs to be performed in a hospital. You’ll have anesthesia and a catheter will be inserted into your bladder to remove urine. After the surgeon removes the mesh, you’ll likely have gauze placed in your vagina to help prevent bleeding.
You may go home that day or stay overnight. Afterward, you can take medication for pain, and vaginal estrogen can help with healing. You may notice some spotting or light bleeding after your operation.
You’ll want to take it slowly as you heal, but short walks can help you recover. You may want to have a family member or friend help you for the first few days after your surgery. You’ll need to talk to your doctor about when you can expect to return to work, based on your job. Generally, women with desk jobs can return to work in about two weeks, while women with more active jobs may need to wait six weeks. In addition, you should avoid sexual activity for six weeks. Most women are back to their normal activities in four to six weeks.
In some cases, you could need a second surgery to remove more of the mesh or to treat an infection or chronic pain.
Alternatives to vaginal mesh removal
Sometimes, women can try other treatment methods to relieve their symptoms without surgery:
- Pelvic floor physical therapy can sometimes help with mild mesh-related symptoms.
- Vaginal estrogen can help with smaller mesh exposures in the vagina, generally less than one centimeter.
- Women who are not sexually active and not suffering from mesh-related pain may be able to have a doctor observe the mesh in the vagina since it often doesn’t get worse.
Options if you want to avoid vaginal mesh
Women who have pelvic floor problems but are concerned about issues with vaginal mesh can talk to their doctors about alternatives, including repairing the pelvic floor with sutures, using other materials instead of mesh and harvesting tissue from another part of the body to use in place of mesh.
The bottom line
Vaginal mesh can be a solution for women who experience pelvic floor problems. But sometimes, the mesh can cause complications and needs to be removed. The procedure can be difficult since the mesh is intended to be permanent, and your body’s tissues grow into it. In some cases, other treatments can help lessen the symptoms without surgery.
You should talk to your doctor if you’ve had vaginal mesh inserted and you’re experiencing any side effects.
Need help evaluating and treating vaginal mesh problems?
Schedule an appointment with a gynecologist near you.