First off, wtf is surgical mesh and why should you worry about it? “Mesh” is a fabric-like material used as a reinforcement for tissue or bone, and for over 50 years it’s been used in surgeries to repair hernias and prevent reoccurrence. So far, so good. But its uses evolved to repairing tissue in the pelvic region, which is where the trouble started. Since then, many patients, the majority of them women, have been doomed to a lifetime of pain and discomfort.
“The Mesh totally ruined my life”
So says Phindile Mncube, who had surgical mesh implanted without her knowledge. “I sometimes can’t even get out of bed and have to ask my mom for help. I can’t go anywhere without drugging myself with pain tablets. The pain affects me in such a way that I can no longer work or play with my kids.”
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In 2016, Phindile was experiencing excessive bleeding and severe period pains. Doctors diagnosed a hematoma and performed surgery to drain it. But after two years, her condition had become . “I was in a lot of pain and constantly sick, so I went to another hospital. [Later] I found out I was put in a mesh. The mesh was put in without my consent and I was kept in the dark about it,” she explains.
But removing it could be life-threatening…
Erosion of the mesh can cause damage to the surrounding organs, but removing surgical mesh is a difficult task – as Phildile found out. “I’d done research about removing the mesh, but the doctor who found it said it’s impossible. The mesh is attached to my intestines and uterus, so it’s too dangerous, life-threatening,” she explains.
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These dangers have resulted in countries like the US, UK, Australia and New Zealand banning or restricting the use of surgical mesh. In a review article, authored by Professor of Materials Engineering at Trinity College Dublin, David Taylor, said: “Chemical degradation of the material due to bacterial infection, and poor surgical technique, are two potential reasons for the failures, but further work is needed — especially the examination of failed mesh products — to properly determine the underlying causes of this problem.”
But while the medical field figures out whether surgical mesh does cause more harm than good, women like Phindile are left to deal with the side effects. “I take pain medication and try to avoid eating inflammatory foods. I also try not to move too much and relax my body most of the time,” she says.
So, what does this have to do with you?
If you’re ever in a position where you might need to have surgical mesh inserted to fix a prolapse or urinary incontinence, talk to your doctor about your options. And as gynaecologist and endoscopic surgeon Dr Natatalia Novikova explains, there are plenty. “Pelvic floor exercises are effective in milder forms of prolapse. We also have new tech such as vaginal laser and radiofrequency non-invasive office procedures, which are helpful for women with mild prolapse,” she says. But in cases where the prolapse is more severe, surgery would be needed.
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Stress urinary incontinence is a condition where women leak urine as they jump, sneeze, cough and run. Traditional treatment includes pelvic floor exercises and, if these don’t work, the next step is a sling procedure, where surgical mesh (much smaller than vaginal surgical mesh used for prolapse repair) is inserted through the vaginal wall underneath the urethra.
“Alternative surgery to a sling is a surgical procedure called Burch (a keyhole procedure where the neck of the bladder is suspended from nearby ligaments with sutures) or an injection of Bulkamid, where a bulking agent is injected around the urethra. It has very promising results for mild to severe stress urinary incontinence,” says Dr Novikova.
The bottom line
While surgical mesh has shown promising results when used to repair hernias, the results from its uses in gynaecological surgeries are less successful. There is no guarantee of how a patient will react to surgical mesh, but discussing your options with your doc will help find the right one for you – one that won’t negatively affect your quality of life.
