Common Vaginal Mesh Injuries Users Should Know

A systematic review of mesh complications in female pelvic floor reconstruction surgery and management indicates that mesh-related complications occur in approximately 10-15% of patients, with some studies reporting rates as high as 25% for certain types of mesh products.

The FDA has described these complications as “not rare,” leading to their decision to restrict certain mesh products for pelvic organ prolapse repair in 2019.

A large-scale study of over 92,246 women tracked over 8 years found that adverse events following mesh procedures varied based on the specific product used and patient factors.

Mesh erosion—where the material protrudes through vaginal tissue—remains one of the most commonly reported issues.

Treatment Pathways for Mesh Complications

When complications occur, treatment options typically advance from conservative to more invasive methods.

For minor mesh exposure, non-surgical approaches such as topical hormone creams may help heal vaginal tissues in certain cases.

Pain management medications can address discomfort while doctors determine the appropriate intervention.

Many complications eventually require surgical correction, including partial mesh removal that targets only problematic sections while preserving well-incorporated areas, complete mesh removal for extensive erosion, infection, or severe pain, and reconstructive procedures following mesh removal to restore proper anatomical support.

According to medical literature, surgical intervention improves symptoms in most patients, though some may need multiple procedures to fully address all complications.

The surgical placement of transvaginal mesh involves precise techniques that have evolved over time as practitioners have gained more experience with these procedures.

While the FDA has restricted the use of transvaginal mesh for pelvic organ prolapse, understanding the surgical approaches remains important for patients considering mesh slings for stress urinary incontinence or those who had mesh placed previously and are now experiencing issues.

The success of these procedures—and the likelihood of avoiding complications—depends heavily on proper surgical technique, appropriate patient selection, and thorough postoperative care.

Vaginal Mesh Insertion Procedures

The surgical placement of transvaginal mesh requires careful attention to anatomical structures and proper tissue dissection.

The procedure typically involves creating a vaginal incision to access the area requiring support, followed by careful dissection to create a space for mesh placement.

For anterior compartment repairs supporting the bladder, surgeons create a midline vaginal incision and dissect the vaginal epithelium from the underlying bladder tissue.

The mesh is then positioned to support the bladder and may be secured to stable structures such as the arcus tendineus fascia pelvis.

In posterior compartment repairs for rectocele, a similar approach involves dissection between the vagina and rectum, with mesh placement to provide support to the posterior vaginal wall.

For stress urinary incontinence, midurethral sling procedures involve smaller incisions and narrower mesh strips.

Common approaches include:

• Retropubic approach (TVT): Mesh is placed beneath the mid-urethra with arms passing behind the pubic bone.
• Transobturator approach (TOT): Mesh is positioned horizontally under the mid-urethra with arms passing through the obturator foramen.
• Single-incision mini-slings: Shorter mesh pieces secured with a single vaginal incision, though these have shown variable success rates.

Surgical innovations to reduce complications have included lighter-weight mesh materials, larger pore sizes for better tissue integration, and more precisely targeted placements to minimize excess mesh.

The trend toward minimally invasive approaches with limited dissection aims to reduce tissue trauma and subsequent inflammation.

After Surgery Care and Monitoring

Postoperative care following transvaginal mesh surgery plays a vital role in detecting potential complications early and ensuring optimal healing.

The immediate recovery period typically involves specific restrictions and monitoring protocols designed to allow for proper tissue integration with the mesh.

Most surgeons recommend restricted activity for several weeks following the procedure, including lifting limitations and temporary abstention from sexual activity.

These precautions allow the initial healing of incisions and help prevent displacement of the newly placed mesh.

Patients are typically monitored for signs of infection, including fever, unusual pain, or abnormal vaginal discharge, and may receive prophylactic antibiotics.

The follow-up schedule for mesh procedures generally includes:

• Initial postoperative visit at 2-4 weeks to check incision healing and basic functionality
• Intermediate follow-up at 3-6 months to assess mesh integration and symptom improvement
• Long-term surveillance at 6-12 month intervals, particularly for patients with risk factors for complications

Imaging studies like ultrasound may be employed when complications are suspected, allowing visualization of mesh positioning and potential erosion before symptoms become severe.

Enhanced recovery after surgery (ERAS) protocols have been applied to mesh procedures in some centers, focusing on multimodal pain management, early mobilization, and standardized care pathways to improve outcomes.

For patients with existing mesh, ongoing vigilance remains important even years after placement, as complications can develop with delayed onset.

Any new symptoms should prompt evaluation by a healthcare provider familiar with mesh complications, ideally one with experience in mesh removal if necessary.

When complications arise from transvaginal mesh, patients face decisions about treatment approaches that balance symptom relief against the potential challenges of additional surgical interventions.

The management of mesh-related issues has developed into a specialized field, with dedicated experts focusing on techniques to address complications while minimizing further harm.

Patients experiencing symptoms have several pathways available, ranging from conservative measures for minor issues to extensive surgical interventions for severe complications.

Treatment Options for Mesh Complications

Managing mesh complications requires individualized care that considers the specific complication type, its severity, the patient’s overall health, and their personal preferences.

The treatment options may range from non-surgical choices to various levels of surgical intervention depending on the clinical presentation.

For minor mesh exposure without symptoms, conservative management may be appropriate.

This option might include topical estrogen therapy to improve vaginal tissue health and potentially assist with covering small areas of exposed mesh.

Close monitoring ensures that the exposure doesn’t worsen over time.

Some patients with mild, tolerable symptoms may choose watchful waiting, particularly if they have medical conditions that increase surgical risks.

The treatment options to address your transvaginal mesh complications include, but are not limited to:

• Partial mesh excision: Removal of only the problematic mesh portion, leaving well-incorporated sections intact. This targeted option may be suitable for localized exposure or erosion when the remainder of the mesh is functioning properly without causing symptoms.
• Complete mesh removal: Excision of the entire mesh implant, which may be necessary for widespread complications, infection, or severe pain syndromes. This procedure often requires extensive dissection and careful identification of mesh arms and anchoring points.
• Staged procedures: Sometimes complete removal is performed in multiple surgeries to reduce operative time and blood loss, particularly for cases involving multiple mesh placements or extensive scarring.

Surgical options may be transvaginal, abdominal (open or laparoscopic/robotic), or a combination depending on the location of the mesh and extent of the complication.

Each option carries different risks and benefits.

The transvaginal route offers direct access to exposed mesh in the vagina, while abdominal options may be necessary to access mesh components near the bladder, bowel, or pelvic sidewall.

Outcome studies show that pain symptoms improve in 60-80% of patients following mesh removal surgery, though complete pain resolution is not guaranteed.

The success rate for resolving mesh erosion is higher, with most patients experiencing resolution after proper excision of the exposed material.

Mesh-Free Options for Pelvic Reconstruction

For patients who require pelvic floor support after mesh removal or those seeking alternatives to mesh for initial treatment, several effective mesh-free approaches exist.

These native tissue repairs use the patient’s own tissues to restore pelvic support without introducing synthetic materials.

Native tissue repairs have experienced renewed interest following concerns about mesh complications.

These techniques have been refined over many decades and offer effective options with potentially fewer long-term complications, though they may have higher anatomical recurrence rates in some studies.

Common native tissue repair approaches include, but are not limited to:

• Anterior and posterior colporrhaphy: Traditional repairs that plicate (fold and suture) the weakened fascial layer of the vagina to reinforce the anterior or posterior compartments.
• Sacrospinous ligament fixation: This technique attaches the vaginal apex to the sacrospinous ligament to provide apical support, especially important after hysterectomy to prevent vaginal vault prolapse.
• Uterosacral ligament suspension: Provides apical support by attaching the vaginal apex to the uterosacral ligaments, which normally support the cervix and upper vagina.
• Iliococcygeus fascia fixation: An alternative apical suspension technique that may be used when the sacrospinous or uterosacral ligaments are unsuitable.
• Fascia lata slings: Uses the patient’s own harvested fascia as material for slings or support, reducing the risk of foreign body reactions but requiring an additional surgical site.

Some surgeons also utilize biologic grafts derived from human or animal tissues as an intermediate option between synthetic mesh and native tissue.

These materials may provide additional support while potentially avoiding some mesh-related complications, though they typically break down over time.

The selection of the appropriate native tissue technique depends on the specific anatomical defect, the patient’s overall health and tissue quality, prior surgeries, and surgeon expertise.

For patients with recurrent prolapse after failed native tissue repair, these procedures can often be repeated or combined with different approaches to address specific weaknesses.

The regulatory landscape surrounding transvaginal mesh has changed dramatically over the past decade in response to mounting evidence of complications and patient advocacy efforts.

These shifts reflect a broader recognition of the need for enhanced oversight of implantable medical devices and greater emphasis on patient-centered care.

Timeline of Vaginal Mesh Injuries Reported

The Food and Drug Administration (FDA) plays a central role in regulating transvaginal mesh products in the United States, with its approach evolving significantly as evidence of complications emerged.

The FDA’s oversight of transvaginal mesh began with relatively limited scrutiny, as many mesh products entered the market through the 510(k) clearance pathway, which allows devices to be marketed without clinical trials if they are deemed “substantially equivalent” to previously approved devices.

As reports of serious complications increased, the FDA took increasingly stringent actions:

• Public Health Notification: In 2008, the FDA issued its first public health notification about complications associated with transvaginal mesh.
• Safety Communication Update: In 2011, the agency released an updated safety communication stating that serious complications from transvaginal mesh were “not rare” and questioning whether mesh offered any advantage over non-mesh repairs for POP.
• Device Reclassification: In 2016, the FDA reclassified transvaginal mesh for POP repair from Class II (moderate risk) to Class III (high risk), requiring manufacturers to submit premarket approval (PMA) applications with clinical data demonstrating safety and effectiveness.
• Market Withdrawal Order: In April 2019, the FDA took its most decisive action by ordering all manufacturers to stop selling and distributing transvaginal mesh products for POP repair. This decision came after the agency determined that manufacturers had failed to demonstrate that the benefits of these devices outweighed their risks.

For patients with existing mesh implants, the FDA does not recommend removal unless complications are present, as removal surgery carries its own risks.

The agency continues to monitor complications from previously implanted devices through adverse event reporting systems and post-market surveillance studies.

Our Transvaginal Mesh attorney at TruLaw is dedicated to supporting clients through the process of filing a Transvaginal Mesh lawsuit.

With extensive experience in product liability cases, Jessica Paluch-Hoerman and our partner law firms work with litigation leaders and medical experts to prove how defective mesh implants caused you harm.

TruLaw focuses on securing compensation for medical expenses, revision surgeries, pain and suffering, lost income, and other damages resulting from your transvaginal mesh injuries.

We understand the physical and emotional toll that Transvaginal Mesh complications have on your life and provide the personalized guidance you need when seeking justice.

Meet the Lead Transvaginal Mesh Attorney at TruLaw

Meet our lead Transvaginal Mesh attorney:

• Jessica Paluch-Hoerman: As founder and managing attorney of TruLaw, Jessica brings her experience in product liability and personal injury to her client-centered approach by prioritizing open communication and personalized attention with her clients. Through TruLaw and partner law firms, Jessica has helped collect over $3 billion on behalf of injured individuals across all 50 states through verdicts and negotiated settlements.

How much does hiring a Transvaginal Mesh lawyer from TruLaw cost?

At TruLaw, we believe financial concerns should never stand in the way of justice.

That’s why we operate on a contingency fee basis—with this approach, you only pay legal fees after you’ve been awarded compensation for your injuries.

If you or a loved one experienced pain, bleeding, infection, organ perforation, mesh erosion, or other complications from transvaginal mesh implants, you may be eligible to seek compensation.

Contact TruLaw using the chat on this page to receive an instant case evaluation and determine whether you qualify to join others in filing a Transvaginal Mesh lawsuit today.

Vaginal mesh lawsuits are being filed by individuals across the country who were injured by defective vaginal mesh implants.

TruLaw is currently accepting clients for the vaginal mesh injury lawsuits.

A few reasons to choose TruLaw for your vaginal mesh injury case include:

• If We Don’t Win, You Don’t Pay: The vaginal mesh injury lawyers at TruLaw and our partner firms operate on a contingency fee basis, meaning we only get paid if you win.
• Expertise: We have years of experience handling medical device cases similar to the vaginal mesh injury lawsuits, which helps us anticipate what we can expect to see in your case and the regulations we will be required to meet.
• Successful Track Record: TruLaw and our partner law firms have helped our clients recover billions of dollars in compensation through verdicts and negotiated settlements.

If you or a loved one suffered injuries from a defective vaginal mesh implant, you may be eligible to seek compensation.

Contact TruLaw using the chat on this page to receive an instant case evaluation that can determine if you qualify for the vaginal mesh injury lawsuits today.