Pelvic mesh has been used in the treatment of pelvic organ prolapse and stress urinary incontinence since the ‘90s and the majority of women who have had surgical treatment continue to have a good long-term outcome; however, some women have experienced complications. Some of these are very serious and life-changing, particularly for women who experience severe chronic pain, have had mesh exposure or erosion into the bladder, urethra or bowel, or recurrent vaginal exposure and infection.
In December 2017, the Therapeutic Goods Administration (TGA), Australia's regulatory authority for therapeutic goods, removed transvaginal mesh solely used for the treatment of most pelvic organ prolapse (such as bladder, bowel or uterine prolapse).
Support is available
The SA Health Pelvic Mesh Consumer Support Line has been established for ‘mesh affected’ women and clinicians seeking support or information about transvaginal mesh.
1800 66 MESH (1800 666 374)
9.00 am to 4.00 pm, Monday to Friday (except public holidays)
Information for women can be found at www.sahealth.sa.gov.au/pelvicmesh
Mesh-related complications and symptoms
Mesh products can cause significant and severe complications for some women including:
- Punctures or lacerations of vessels, nerves, structures or organs, including the bladder, urethra or bowel, requiring surgical repair.
- Mesh extrusion, explosion or erosion into the vagina or other structures or organs.
- Acute and/or chronic pain; or neuromuscular problems.
Symptoms that may be associated with pelvic mesh implant complications include:
- pain that is not improving - low abdominal, pelvic, groin, thigh or buttock pain
- poking / prickling sensation or spasms in the pelvic area
- you or your sexual partner feeling the mesh through the vaginal wall
- pain (either you or your sexual partner) during sexual intercourse
- abnormal vaginal bleeding or discharge
- difficulty with bladder emptying
- pain associated with urination
- recurrent bladder infections
- abscess or swelling at the mesh insertion or exit sites.
SA Health is currently developing clinical referral pathways and dedicated pelvic mesh clinics, with support provided from a multidisciplinary team, including an Urogynaecologist, pain management specialist, clinical psychologist, pelvic floor physiotherapist specialist, continence specialist nurse, social worker and ultrasound specialist.
Women who have had mesh inserted and are exhibiting symptoms should have a physical examination of their abdomen, pelvis and vagina. A pelvic ultrasound is required, as well as referral to a gynaecologist or gynaecologists with special interest in urogynaecology.
- If possible, consult with the original surgeon. If you are unsure if mesh was used you can order a pelvic floor ultrasound to confirm the presence of pelvic mesh.
- Refer to a gynaecologist with experience in managing women with mesh complications.
- Report any suspected mesh-related adverse events to the TGA.