Transvaginal mesh

What is transvaginal mesh?

Transvaginal mesh is a synthetic net-like substance that provides extra support to repair weakened or damaged internal tissue.

It is known as 'transvaginal' mesh as it is implanted in a surgical procedure via the vagina. Transvaginal mesh can also be known as tape, sling, ribbon or hammock.

The mesh has holes in it to allow the body’s own tissues to grow into the mesh. It is intended to be permanent and may not be able to be removed if complications arise.

When is transvaginal mesh used?

Transvaginal mesh is used to treat stress urinary incontinenceif non-surgical treatment options have been unsuccessful. It is only one of the surgical options that are available.

It has been withdrawn in Australia for the treatment of most pelvic organ prolapse (such as bladder, bowel or uterine prolapse). In November 2017, the Therapeutic Goods Administration removed products solely used for this surgery from the Australian Register of Therapeutic Goods.

If you are considering having transvaginal mesh implanted

As with all medical procedures, it is important for you to fully understand the transvaginal mesh implant procedure, and weigh up the risks and benefits before you make a decision. This is known as informed consent.

Ask your specialist as many questions as you need, such as:

• What are the other treatment options?
• What are the benefits of this procedure?
• What are the risks of the procedure and additional risks associated with using mesh?
• What will happen if I do not have the procedure?
• What will this procedure involve?
• What type of mesh will you be using? What are the risks and complication rates of this procedure?
• Are you trained to perform this procedure? How many have you performed? What were the results?

Other questions to ask are included in our Informed consent for medical treatment factsheet.

You may also wish to seek a second opinion.

Complications with transvaginal mesh implants

While many women who have transvaginal mesh experience no difficulties, a number do.

Women can experience difficulties with transvaginal mesh immediately after their operation or years later.

Complications may range from mild discomfort to debilitating pain, including:

• irregular vaginal bleeding or discharge
• pelvic pain or swelling
• discomfort during sex
• bladder and bowel problems like infection and incontinence
• prickling feeling or sharp stabbing pain in the vagina, which may become worse with exercise
• abdominal, buttock or leg pain.

For a complete list of complications from the use of transvaginal mesh implants visit the Therapeutic Goods Administration website.

Are you experiencing pain or discomfort?

Seek medical advice

We know it can be hard to talk about personal health problems, even with a doctor. Here are some questions to help you have that conversation with your doctor:

• If I have mesh complications, are you able to treat them and how?
• Can the type of mesh I have be removed?
• What are the surgical options, what are you recommending and why?
• Will my symptoms go away if the mesh is removed?
• What are the alternatives to surgery?
• What will happen if I choose not to have surgery?

Support services available

Victorian mesh information and helpline

Call Tel. 1800 55 6374 (1800 55 MESH) during business hours to speak with registered nurses about your clinical options, and to help you find the right service in Victoria.

Peer support

Share practical information and emotional support with women who have similar experiences in peer to peer support groups facilitated by a qualified health professional. Contact: tvmeshsupport@whv.org.au or visit www.whv.org.au

Hospital programs

These hospitals have specialist programs to help women with complications from mesh:

• Royal Women’s Hospital Tel. (03) 8345 3143
• Mercy Hospital for Women Tel. (03) 8458 4500
• Monash Health Tel. (03) 9928 8588
• Western Health Tel. 0481 908 118.

Other materials

Download the Australian Commission Safety and Quality in Health Care.

Alternative treatment options to transvaginal mesh

Non-surgical and surgical treatment options not using transvaginal mesh are available for women with pelvic organ prolapse and stress urinary continence.

Non-surgical treatments

Non-surgical treatments include:

• pelvic floor physiotherapy – strengthening the pelvic floor through actively tightening and lifting the muscles at intervals (see a physiotherapist who specialises in pelvic floor training). Additional treatments such as electrical stimulation and biofeedback may assist with improving your pelvic floor muscle function.
• bladder training
• medication
• vaginal pessary – a ring-like device that sits in the vagina helping to support the pelvic organs reducing descent and/or stress urinary incontinence. These can lead to significant improvements in prolapse symptoms and in bladder and bowel function
• lifestyle changes – including reducing weight, avoiding heavy lifting, and treatment of constipation and chronic coughing
• absorbent products – these can help manage incontinence problems for some women.

Surgical treatments (other than mesh)

Alternative surgical treatments include:

• native tissue repair – where the patient’s own tissue is used to repair the prolapse
• biological graft repair – uses a graft from a source, such as human or animal tissue, to support the vaginal prolapse
• pubovaginal sling – using the patients own tissue
• colposuspension – can be open or laparoscopic
• bulking agents – these are injected into the urethra.

More information

Report to the Therapeutic Goods Administration (TGA)

You can report any adverse events directly to the (TGA). Tel. 1800 809 361 (business hours only). Visit the TGA website.

Charter of Healthcare Rights

You have the essential right to access high quality and safe healthcare, wherever and whenever care is provided. Find out more about the Australian Charter of Healthcare Rights.

Health Complaints Commissioner

Anyone can make a complaint about any health service provided in Victoria. You can also make a complaint about anyone who holds your health records. Visit the HCC website.

Freedom of Information Commissioner

If you are unable to access your health records from your health service or doctor, you can request these through Freedom of Information. Visit the Office of the Victorian Information Commissioner website.