Get answers to the most frequently asked questions about mesh and pelvic floor surgery.

When is mesh used for pelvic floor surgery?

Mesh is used in different types of pelvic floor surgery including:

• Slings for stress incontinence
• Abdominal or robotic-assisted surgeries for pelvic organ prolapse, such as a sacral colpopexy
• Transvaginal procedures for prolapse

The recent U.S. Food and Drug Administration (FDA) safety communication was specifically focused on transvaginal placement of mesh for pelvic organ prolapse. This means the mesh is placed through a vaginal incision.

Do all prolapse surgeries use mesh?

No, some surgeries use mesh while others do not. Depending on the amount of bulge (prolapse) and other factors, your surgeon may or may not recommend a surgery that includes mesh.

The surgeons in the Duke Division of Urogynecology are well-informed regarding the pros and cons of using mesh. Your surgeon is up-to-date on the recent FDA information and is happy to discuss whether or not a mesh repair may be considered for you.

What were the key points of the FDA safety notification?

• Mesh used in transvaginal prolapse repair introduces risks not present in non-mesh approaches.
• Mesh placed abdominally for prolapse repair appears to result in lower rates of mesh complications than when mesh is placed through a vaginal incision.
• While transvaginal surgical repair to correct weakened tissue between the bladder and vagina with mesh may provide an anatomic benefit compared to prolapse repair without mesh, this anatomic benefit may not result in better symptomatic results.
• The most common complication from transvaginal mesh procedures is mesh erosion, which is when the mesh becomes exposed on vaginal tissue and the risk is approximately 10 percent. Other potential complications include:
• Pain
• Infection
• Bleeding
• Pain during sexual intercourse
• Injury to surrounding organs
• Urinary problems 

There may also be the need for hospitalization or additional surgeries to treat complications or to remove the mesh. 

Why should I consider a surgery with mesh?

In some instances, a permanent mesh can provide better long-term results than repairs without using mesh.

A mesh repair is recommended for some patients because they have factors that put them at risk for having a recurrence of prolapse if they use their own tissue. Some surgeries, such as slings for urinary leakage, use a very small piece of mesh. 

Again, the FDA notification in July 2011 does not apply to mesh surgeries for urinary incontinence. 

Depending on your history and your symptoms, your surgeon is prepared to advise you regarding which surgical procedures may be the best for you. Ultimately, the final decision is yours.

If I have a procedure with mesh, what should I watch for?

If you have unusual bleeding, discharge, or pain with intercourse you should contact your surgeon. You will likely be asked to come in for examination to determine the cause of your symptoms.

Where can I get more information about the FDA safety notification?

You can find additional information about the FDA safety notification on the FDA's Web site (FDA.gov).

You may also review the FDA report (PDF, 243 KB).