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Patch Applications in Uterine Prolapse

If you're a woman with a pelvic floor disorder (incontinence or prolapse of the uterus and vagina) you've probably heard of surgeries involving mesh (patch). However, reports of complications may cause you confusion and hesitation in treatment.

What is surgical sling (mesh)?

Surgical mesh is a medical product used to provide extra support while repairing weakened or damaged tissue. Most surgical mesh is made from synthetic materials or animal tissue.

How is surgical mesh used to treat pelvic floor disorders?

Surgical mesh can be used for the following reasons:

Pelvic organ prolapse (POP):

When the muscles and ligaments that support a woman's pelvic organs weaken, pelvic organs may droop and swell in the vagina (pelvic organ prolapse). To treat POP, surgical mesh may be implanted to strengthen the weakened vaginal wall. The surgery can be done through the abdomen using a sling or through the vagina without using a sling. Currently, there is no vaginal surgery using a sling.

Stress-induced urinary incontinence (SUI):

This refers to the involuntary loss of urine due to a physical movement or activity such as coughing, sneezing, running, or heavy lifting that puts pressure (stress) on the bladder. A surgical urethral sling can be implanted vaginally to support the urethra or bladder neck. This is known as the mid-urethral suspension procedure.

What are the safety concerns regarding the use of surgical slings to treat pelvic floor disorders?

The use of hangers has its own risks and benefits. In vaginal sling use to treat POP, protrusion of the sling from the vaginal mucosa has been associated with higher rates of sling-related complications, such as pelvic pain or pain with intercourse. In 2019, the FDA ordered that products needed for the transvaginal repair of POPs cease to be sold and distributed in the United States. If you have previously had a transvaginal sling for surgical repair of the POP, continue with your routine care. Talk to your doctor if you have complications or symptoms.

What questions should I ask before looking for knitting therapy for pelvic floor disorder?

If you are considering treatment for a pelvic floor disorder that includes a surgical sling, ask your doctor to explain all the options, as well as the potential risks and benefits.

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