In April 2019, the FDA ordered manufacturers to stop producing mesh specifically to be implanted vaginally for prolapse repair. Women who have undergone these procedures in the past should continue to receive routine check-ups and alert their doctor if they experience any symptoms.
The FDA ruling does not apply to mesh that is placed for stress urinary incontinence or placed for abdominal/robotic prolapse repair (sacrocolpopexy). Duke urogynecologists continue to safely and effectively perform these procedures.
Sacrocolpopexy for Vaginal Prolapse
Robotic tools are used by surgeons to correct vaginal prolapse laparoscopically and support the pelvic floor with a synthetic mesh that is anchored to the cervix through small incisions in the abdomen. Robotic surgery affords your surgeon more precision in performing the procedure. It also avoids the need for a large abdominal incision, which reduces infection risk associated with open surgery. You resume your normal activities faster.
Vaginal Repair of Prolapse Without Mesh
Vaginal prolapse can be repaired through the vagina without the use of vaginal mesh. This option may be appropriate for some people, and allows for a quick recovery without any abdominal incisions.
Burch Procedure for Stress Incontinence
Two stitches are placed on the bladder through a small incision. Primarily recommended to women who suffer from stress incontinence and do not wish to have a mesh procedure, or who may be having additional surgery such as a hysterectomy.
Mid-Urethral Sling for Stress Incontinence
Newer mesh technologies are used to create a soft “hammock” which is placed under the urethra through small incisions. It provides support during laughing, coughing and lifting, and prevents stress incontinence. Patients go home the same day and can return to work within a few days.
Fascia Pubovaginal Sling for Leakage
Tissue from your body or from a donor is placed under the urethra. This option has proven effective for women with severe leakage as well as women who have undergone radiation, or who may not tolerate the mesh sling.