Additional surgeries to treat incontinence, according to results of a study which was published very recently in Urology Times, may be required in women who had sling mesh removal after experiencing adverse complications. After causing serious injuries to thousands of women due to complications attributed to these mesh contraptions, it may be worth noting that these sling devices are now the subject of multiple lawsuits. Several lawsuits have been filed in courts all over the country with those claims consolidated under a multidistrict litigation (MDL) in West Virginia proceeding satisfactorily, legal experts say.
Being aware of the possible adverse effects of a sling mesh removal, especially to those planning to undergo pelvic mesh surgeries for their stress urinary incontinence (SUI) makes this research a very important one. It may be recalled that the Food and Drug Administration (FDA), in conformity with the stand of the American Urogynecology Society (AUGS), did not take a strong stance against sling mesh procedures unlike the use of vaginal mesh implants for the repair of pelvic organ prolapse (POP).
The first stage of the study, initiated by Dr. Leah Nakamura, a urology fellow at the University of California at Los Angeles and an associate of the noted mesh specialist Dr. Shlomo Raz, was in the review of records dating January 2001 up to May 2013 in order to identify women who had undergone sling mesh removal. Selected for the study was an initial group of 110 patients which was later reduced to 96 women after 14 patients were eliminated.
The subjects had a mean age of 56.6 years, body mass index of 27.6 kg/m2, and experience child delivery 2.7 times. Between the implantation of the sling and its removal, it was found that an average of 2.84 years elapsed. Reasons given for the removal of the mesh included mesh erosion, urinary retention, obstructive or irritative symptoms, pain, and recurrent urinary tract infections.
It was determined, at the conclusion of the study, that 62 patients or 64.6 percent experienced SUI after sling mesh removal procedures. Included in this were 11 patients who did not suffer incontinence prior to the mesh removal operations. At least half of these women required surgical operations to address this new incontinence problem with 16 of them needing to undergo more than one surgery.
Notwithstanding the FDA’s endorsement of this procedure which it found to have a high success rate, the findings of this study are very important in making a decision whether to have a mesh sling surgery for the repair of SUI. Having to suffer a new set of urinary complications after trying to remedy an earlier complication brought about by these mesh implants would be like adding insult to injury.