FDA: Repairing Pelvic Organ Prolapse With Mesh Risky
Risks Include Pain, Infection, Need for Additional Surgery
FDA: Risks Outweigh Benefits continued...
“This is not an indictment of surgical mesh,” he says. “We are talking about a very specific use of surgical mesh."
There may still be a role for mesh in certain transvaginal pelvic organ prolapse procedures, he says.
“Some clinicians believe that the use of mesh for transvaginal pelvic organ prolapse is appropriate and is the best treatment option for selective patients such as those with severe pelvic organ prolapse,” he says.
Women who have had surgery for pelvic organ prolapse need to understand whether or not their procedure involved mesh. “For someone considering having a procedure for pelvic organ prolapse, speak with a doctor and understand if the surgery is going to use mesh, and ask about the benefits and why the decision was made,” he says.
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Elizabeth A. Poynor, MD, a pelvic surgeon at Lenox Hill Hospital in New York City, has never used mesh for transvaginal pelvic organ prolapse and likely never will.
“I don’t use mesh in my practice because I have seen a significant number of complications from other surgeons, and have seen how mesh erosion can be devastating for patients,” she says.
As to why use of mesh implants for this surgery took off in the first place, she says it may have a lot to do with the complexity of the procedure.
“This is one of the most detailed and complicated surgeries that we do and unless it is done correctly, it can have a significant chance of failing,” she says. Some surgeons believe the mesh boosts the chances of a successful surgery.
“There has been the general feeling that repairs are better and sounder if mesh is used, but mesh may not be better than the proper surgical correction,” she says.
“Women who are considering prolapse surgery should review the risks, benefits, and alternatives with their surgeon to make sure that it is the right choice,” Poynor says.
“This has been a long time coming,” says J. Eric Jelovsek, MD, a staff physician in the Obstetrics, Gynecology, & Women's Health Institute of the Cleveland Clinic in Ohio.