Alternatives to Mesh - Hystersisters Hysterectomy Article

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Alternatives to Mesh

Alternatives to Mesh

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Ask A Doctor

I don’t want my surgeon to use mesh in my prolapse repair. How do they do a prolapse repair without mesh? How successful is mesh-free repair?

Due to a recent FDA warning about possible complications from pelvic floor repair surgeries using synthetic mesh or tape, many doctors and patients are shying away from its use. Though synthetic mesh is quite effective for other types of surgeries, such as hernia repairs, the complication rate from mesh use in pelvic organ prolapse (POP) repairs is calling its use into question for gynecological surgeries.

Though there has been a great deal of success using human (cadaver) or porcine (pig) fascia (connective tissue) to create biomesh, there is a slight risk of tissue rejection. Therefore, instead of synthetic mesh or biomesh from outside sources, some surgeons will propose using the patient’s own fascia to fashion an organ sling to reinforce stitching. The fascia can be harvested from a thigh or the abdomen during the POP repair surgery. The surgeon removes a narrow strip of tissue several inches long from which to create a sling for the bladder. The surgeon anchors the sling to strong tissues in the patient’s pelvis at either end, forming a tension-free “hammock” to help hold up the bladder. Since the sling is made of the patient’s own tissue, there is no risk of rejection. And since it is not a synthetic material, erosion into the vagina is unlikely as well.

Other doctors will opt to perform POP repairs with stitches only, using no slings or reinforcing materials at all. Though this method carries the risk of stitches failing to sufficiently support the healing pelvic structures or from the reoccurrence of prolapse years later, it has fewer overall complications than sling and mesh methods as a general rule.

Some Sisters who have had each type of repair performed report being satisfied with the outcome, while others have suffered complications and further surgeries. Ultimately, you will want to research your options, discuss those options with a urogynecology specialist, and seek a second opinion before making your decision. Much of it will depend on your specific prolapse type, severity, and symptoms. Also important is your surgeon’s experience and comfort level with the method you choose. Note that, while complications from mesh repairs are no longer considered to be “rare” by the FDA, the great majority of women who do get POP repairs using mesh do have satisfactory outcomes. If your doctor insists on its use for your repair and you are still uncomfortable, just seek a second or third opinion to satisfy your concerns before committing to it, and move on to a different surgeon if you decide against mesh after all.

This content was written by staff of HysterSisters.com by non-medical professionals based on discussions, resources and input from other patients for the purpose of patient-to-patient support.

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Gerald Harkins, M.D. Department of OB-Gyn P.O. Box 850, H-103 Hershey PA 17033 717-531-6447	Richard W Farnam, M.D. 1700 N. Oregon Suite 520 El Paso TX 79902 9155335600	Melanie Bone, M.D. 5301 S. Congress Ave. Atlantis FL 33462 561-548-8600
Christopher Stroud, M.D. 11123 Parkivew Plaza Drive Suite 101 Fort Wayne IN 46845 2609695071	Geoffrey Bowers, M.D. 834 Chestnut Street Suite 300 Philadelphia PA 19107 215-955-5000	Kym Boyman, M.D. 1775 Williston Rd., Ste. 110 South Burlington VT 05403 802-735-1252
Stephen Zweibach, M.D. 815 S Parsons Ave Brandon FL 33511 8135712777	Susan Carter, M.D. North Colorado Medical Center/ MCR 1800 15th Street, Suite 220 Greeley CO 80631 970 353 1335	Wilfredo R. Ramos, M.D. 5301 F Street, Suite 210 Sacramento CA 95819 (916) 453-3440

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