The Transvaginal Mesh is the commonly used term to describe solution for women who experience stress incontinence.
Stress incontinence is a form of urinary incontinence that is caused by insufficient strength of the pelvic floor muscles, which some amount of urine loss may be involuntarily caused by coughing, sneezing, lifting heavy things, and so on.
Minimally invasive or Non invasive methods of controlling stress incontinence are weight loss, exercise and other lifestyle changes, pelvic floor exercises (also known as Kegel’s exercises), Biofeedback, electrical stimulation, pessaries for vaginal insertion and so on.
Among the surgical methods of controlling or reversing stress incontinence certain kinds of mesh slings consisting of different materials to create a hammock like supporting structure for the urethra.
There are mini-slings, tension-free transvaginal tape, the trans-obturator tape and the tension-free transvaginal| (TVT) sling procedures that are effective in countering stress incontinence.
The tension-free transvaginal (TVT) sling or the transvaginal mesh as it is also called, involves the placing of a mesh tape under the woman’s urethra. Two small incisions are required for the procedure, which takes as little as 20 minutes and which is statistically seen to work in up to 95% of cases.
This claim of 95% efficacy however has later been retracted by the study authors and there are now serious questions being raised about not just the efficacy but also the safety of the transvaginal mesh.
There are possibly serious complications that can arise from the procedure – if the procedure is not carried out correctly or with requisite skill, it can lead to bladder perforation.
Also the possible complications that may occur in the longer term, or several years after the insertion of the mesh are not fully understood though mesh erosion has been noted in a number of cases.
The FDA has recently announced its concerns about the use of the transvaginal mesh for treating conditions such as pelvic organ prolapse (POP) and has spoken out about safety concerns that they have had regarding the procedure.
Many complications resulting from the procedure when used for treating stress incontinence as well as POP have been reported in recent times and the safety and efficacy of the procedure is being reevaluated by the FDA.
The worry is that the rectum, bladder and/or uterus can actually slip out of place due to the implant of the mesh whereas there is not enough evidence to indicate that it improves conditions such as pelvic organ prolapse.