What goes wrong with Bladder Slings?
Though designed to reduce the body’s inflammatory response, none of these meshes are infallible, resulting in some problems in patients. Patients who received abdominal incisions for POP treatments did not develop problems until a year and a half after surgery, while patients who underwent transvaginal placement experienced complications as early as a month to four months after surgery.
These complications include but are not limited to:
- Chronic pain in the pelvic, genital or groin regions
- Nerve damage
- Bruising and hematomas
- Vaginal scarring, discharge, and shrinkage due to scar tissue)
- Bleeding in the stool or urine
- Neuro-muscular problems
- Infections (including urinary tract infections)
- Autoimmune problems
- Obstruction of the urethra
- Erosion of the vaginal tissues (such as when mesh erodes and passes through the vaginal wall)
- Organ perforation (injuries to bowel or bladder from exposed edges of the mesh)
- Injuries to blood vessels with massive hemorrhage
- Painful sexual intercourse or sexual dysfunction
- Emotional problems
- In some cases, the procedure did not only create pain, but patients also experienced a recurrence of their initial symptoms of prolapse or incontinence. From 2005 to 2011, the FDA received 4,000 reports of complications related to transvaginal mesh surgeries.
What is a revision surgery?
Sometimes after transvaginal mesh implantations, meshes might need to be repositioned or totally removed in procedures known as revision surgeries. The type of complication and severity of symptoms determines the type of revision surgery necessary for the patient.
Revision surgeries, also known as excisions, could require women to undergo multiple surgeries, waiting with pain while doctors determine the best next step. The doctors most suitable for the task are urogynecologists, who have special training in pelvic floor disorders, like POP and SUI, and therefore specialize in transvaginal mesh revisions and removals.
Considering most meshes are sewn into the vagina as a permanent fix to POP or SUI, removal of the mesh is extremely tough. As soon as the mesh was placed in the body, blood vessels and tissues began forming around the foreign device, making excision complex for the surgeon and painful for the patient. Typically, the surgeon must cut out the mesh in pieces from the surrounding tissues before stitching the area back together. Should removal be necessary, it is not uncommon for patients to experience up to seven surgeries.
In light of this, many doctors might not perform revision surgery in the first place but might recommend a patient visit a urogynecologist for expertise. If surgery is not an option for a patient, alternative methods to mesh removal include the following:
- Estrogen cream, which helps a vagina wall heal without surgery
- Manage symptoms, which is easier if a woman is not sexually active
- Trim exposed mesh, if only a small amount of mesh is exposed (using a local anesthetic)
Mesh removal should be a last resort if these methods are not successful. The technique and type of mesh used in the original procedure determine how a doctor will remove the mesh. Some studies indicate that only 45-percent of patients no longer have symptoms after the mesh is removed. Furthermore, after these surgeries, the prolapse still must be addressed. Many doctors are now reverting to non-mesh solutions.
Bladder Sling Revision Surgery Lawsuits
Bladder Slings and Vaginal Mesh have lead to countless lawsuits. There are various theories as to why so many of these Mesh implants have failed. The lawsuits are filed all over the country and are against the companies who made the mesh. (Mostly) There are a few cases involing medical providers, but most are product liability lawsuits against corporations such as Bard, Boston Scientific and Ethicon.
One of the central areas where cases are filed in is a Federal Court in West Virginia. This is where the Multidistrict litigation for the cases is centered.
Determining whether you have a case usually involves collecting and reviewing medical records to find a whole list of things. Burke & Eisner is one place with information on Bladder Sling Lawsuits.
Studies have been done showing the having a mesh removal may have mixed results.