Sherri,
I'm glad to hear you are going back this week and next week. Can you tell us what type of suburethral sling mesh was used? I found this research study regarding the specific Mersilene mesh. If your doctor did not use this particular brand, there may still be some good information for you. It seems as there is an 8% mesh erosion rate post-surgery.
2009 article: "Postoperative erosions of the Mersilene® suburethral sling mesh for antiincontinence surgery". author: Kyle J. Wohlrab,
Division of Urogynecology, Women & Infants’ Hospital/Alpert Medical School of Brown University, 695 Eddy Street, Suite 12, Providence, RI 02903, USA
You may choose to email the author or this clinical study, if you would like further information: Kyle J. Wohlrab: [email protected]
Journal: Int Urogynecol J Pelvic Floor Dysfunct. 2009 April; 20(4): 417–420. Published online 2008 December 13. doi: 10.1007/s00192-008-0787-4.
From PubMed, accessed at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2883768/
"We identified 772 suburethral sling procedures utilizing Mersilene® mesh between January 1996 and May 2007. We identified 86 cases of sling revisions performed at the institution during that time period. Ten cases were excluded because they were revisions/removals of erosions from other synthetic materials: the ProtoGen sling in three cases, polyproprelene mesh in four cases, and permanent sutures following Burch urethropexy in three cases. Seventy-six cases were identified during the study period for complications from Mersilene® mesh. Fourteen women had undergone more than one surgical revision of the same mesh erosion. Thus, a total of 62 separately identifiable women underwent surgical revision or excision of a Mersilene® sling, giving an estimated overall erosion rate of 8% (62 of 776)."
"The most common complaints were vaginal discharge (37%) and vaginal bleeding (31%). Pelvic pain/dyspareunia was reported by 13% (eight of 62) of women, and all these women presented within 3 years of the initial sling procedure. Twenty-one percent (13 of 62) of women complained of irritative voiding symptoms (e.g., urinary frequency, dysuria) and/or recurrent urinary tract infections as their presenting symptom."
Treatment:
"Prior to undergoing complete surgical excision, some women had attempts at treatment of their Mersilene® mesh erosion with conservative strategies. Seven women underwent trimming of the exposed mesh in the office prior to their surgical procedures. Six women were treated with vaginal estrogen cream in an effort to promote healing."
Possible Cause:
"Mesh erosions are thought to be caused by some degree of bacterial colonization/infection within the mesh [9]. The higher erosion rates of erosions found in this study are consistent with the properties of the Mersilene® mesh. "
"Our study did include 14 women who had undergone repeat procedures, which suggests that surgical revision, i.e., not removal, is likely to be of benefit only when the sling is not colonized with vaginal or anaerobic flora."
"Cystoscopy should be considered for women with irritative voiding symptoms and a history of mesh placement as these symptoms were present in women noted to have mesh within the bladder on cystoscopy."
"The recent shift in the development of synthetic materials has favored a macroporous monofilament structure that allows tissue in-growth while also allowing macrophages to traverse its framework in search of residing bacteria. Thus, the use of Mersilene® mesh has fallen out of favor. "
Comment Reply
Sherri,
I'm glad to hear you are going back this week and next week. Can you tell us what type of suburethral sling mesh was used? I found this research study regarding the specific Mersilene mesh. If your doctor did not use this particular brand, there may still be some good information for you. It seems as there is an 8% mesh erosion rate post-surgery.
2009 article: "Postoperative erosions of the Mersilene® suburethral sling mesh for antiincontinence surgery". author: Kyle J. Wohlrab,
Division of Urogynecology, Women & Infants’ Hospital/Alpert Medical School of Brown University, 695 Eddy Street, Suite 12, Providence, RI 02903, USA
You may choose to email the author or this clinical study, if you would like further information: Kyle J. Wohlrab: [email protected]
Journal: Int Urogynecol J Pelvic Floor Dysfunct. 2009 April; 20(4): 417–420. Published online 2008 December 13. doi: 10.1007/s00192-008-0787-4.
From PubMed, accessed at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2883768/
"We identified 772 suburethral sling procedures utilizing Mersilene® mesh between January 1996 and May 2007. We identified 86 cases of sling revisions performed at the institution during that time period. Ten cases were excluded because they were revisions/removals of erosions from other synthetic materials: the ProtoGen sling in three cases, polyproprelene mesh in four cases, and permanent sutures following Burch urethropexy in three cases. Seventy-six cases were identified during the study period for complications from Mersilene® mesh. Fourteen women had undergone more than one surgical revision of the same mesh erosion. Thus, a total of 62 separately identifiable women underwent surgical revision or excision of a Mersilene® sling, giving an estimated overall erosion rate of 8% (62 of 776)."
"The most common complaints were vaginal discharge (37%) and vaginal bleeding (31%). Pelvic pain/dyspareunia was reported by 13% (eight of 62) of women, and all these women presented within 3 years of the initial sling procedure. Twenty-one percent (13 of 62) of women complained of irritative voiding symptoms (e.g., urinary frequency, dysuria) and/or recurrent urinary tract infections as their presenting symptom."
Treatment:
"Prior to undergoing complete surgical excision, some women had attempts at treatment of their Mersilene® mesh erosion with conservative strategies. Seven women underwent trimming of the exposed mesh in the office prior to their surgical procedures. Six women were treated with vaginal estrogen cream in an effort to promote healing."
Possible Cause:
"Mesh erosions are thought to be caused by some degree of bacterial colonization/infection within the mesh [9]. The higher erosion rates of erosions found in this study are consistent with the properties of the Mersilene® mesh. "
"Our study did include 14 women who had undergone repeat procedures, which suggests that surgical revision, i.e., not removal, is likely to be of benefit only when the sling is not colonized with vaginal or anaerobic flora."
"Cystoscopy should be considered for women with irritative voiding symptoms and a history of mesh placement as these symptoms were present in women noted to have mesh within the bladder on cystoscopy."
"The recent shift in the development of synthetic materials has favored a macroporous monofilament structure that allows tissue in-growth while also allowing macrophages to traverse its framework in search of residing bacteria. Thus, the use of Mersilene® mesh has fallen out of favor. "
August 17, 2010 - 8:56pmThis Comment
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