What’s the scoop with mesh?

Written by Sarah Boyles

On February 27, 2021
choices

There is a lot of media and legal attention on surgical mesh in the US.  I think it is important to understand all of this prior to making a decision about surgery.  There are several points to make to understand the surgical mesh in bladder surgery story. So take a deep breath and read on.

Surgical mesh is the standard of care in bladder surgery

The first point is that mesh slings are standard of care to correct stress urinary incontinence in the US.  They consistently work very well. But please don’t take my word for it.  Read more about it from our national organizations here.

All surgeries have risk

The second point is that all surgeries have risk.  There can be complications even in the best of hands.  Mesh surgeries have a unique complication that non-mesh surgeries do not have.  And that is the risk of erosion.  A small bit of mesh can migrate to a spot where it was not placed.  For surgical meshes used in bladder surgery, the most common spot for an erosion is the vagina. This happens in about 2% of cases.  Read what the FDA says about this here.

Mesh slings are well-researched

The third point is that we’ve learned a lot about mesh over time.  There have been some “bad meshes” that had higher rates of complications.  Those meshes are long off the market.  The meshes used now are macroporous (the holes in the mesh have to be big because it impacts infection risk), monofilament (the meshes are made from one strand because this too impacts infection risk) polypropylene.  Bladder surgeries using this surgical mesh are the most studied anti-incontinence procedure in history.  So many studies have been done because we want to make sure we get it right.

Transvaginal mesh surgeries

The last point is that some mesh procedures have been taken off of the market by the FDA.  These surgeries used the same mesh but the surgeries were to correct pelvic organ prolapse.  The mesh was placed differently than an incontinence mesh.  These surgeries are called transvaginal mesh surgeries and do not include incontinence procedures.

 There is so much out there on this topic.  I really like these two articles from the Cleveland Clinic and Yale Medicine.  Educate yourself.  Don’t be afraid of mesh but understand it.  And if you choose not to use it, that is ok. You can read about surgeries for leaking that don’t involve mesh here.

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