We believe it is important to review all treatment choices with you, everything from conservative therapy to the most advanced and complex pelvic reconstructive surgeries.
If you're dealing with urinary incontinence or vaginal prolapse, we believe you should first be offered non-surgical treatment options such as physical therapy, pessary or clinical observation to improve pelvic floor muscle function – before considering a surgical treatment.
Maybe you've had failed native tissue repairs for vaginal incontinence and prolapse, leaving you with recurrent symptoms of incontinence, vaginal bulge, pain or infections. The failure rate of a primary native tissue repair can be as high as 40% and the failure rate is even higher for a re-do of a native tissue repair.
The use of vaginal mesh augmentation for prolapse and incontinence surgeries has been used for nearly 20 years.
Our board certified surgeon is an expert in vaginal mesh implants and revisions, doing hundreds of these types of complex surgeries every year.
In fact, women come from around the country to seek our surgical expertise to restore their normal anatomy. We coordinate a tailored care plan to get them back to normal bowel, bladder and sexual function.
At your initial visit, we’ll take a thorough history and perform an exam to make sure no other problems—such as occult vaginal mesh erosion or extrusion, recurrent prolapse or pelvic floor muscle issues—are present that need to be addressed.
A voiding diary (journal where you record what you drink and urinate for 48 hours) can help us identify holistic treatment options, such as simple behavioral modification.
We will spend time reviewing available treatments for your pelvic symptoms. This may begin with:
- Improving pelvic muscle function through physical therapy
- Biofeedback
- Local injection therapy
- Pelvic relaxation exercises
- Addressing vaginal atrophy or infections
If a procedure or surgery is necessary, we then proceed with two tests:
Cystoscopy, where we look in your bladder with a small scope to assure there’s no mesh or injury to the bladder
Urodynamics testing to see how the bladder functions before finalizing a surgery decision.
We also believe it is important to maximize pelvic floor muscle function prior to any surgical procedure for the best possible results.
Our surgeon is committed to answering your questions so you understand the risks, benefits, options and expected outcomes of any mesh surgery or mesh revision.
Our team will see you through surgery, recovery and rehabilitation to restore the most intimate parts of your body.
You may have heard that the FDA has ordered the manufacturers of surgical mesh used for transvaginal repair of anterior compartment prolapse (cystocele) to stop selling their products immediately.
It’s important to note this is not because of reported problems with the mesh, but because the manufacturers have not demonstrated reasonable assurance of safety and effectiveness for these devices. For more details on this, visit the FDA information page.
We realize you may have some questions about this.
If you received transvaginal mesh for the surgical repair of prolapse, please continue with your annual and other routine check-ups and follow-up care. There is no need to take additional action if you are satisfied with your surgery and are not having any complications or symptoms.
If you have complications or symptoms, including persistent vaginal bleeding or discharge, pelvic or groin pain or pain with sex, you should notify your health care provider.
You should also let your health care provider know if you have surgical mesh so it can be entered into your medical record, especially if you plan to have another surgery or other medical procedures.
If you were planning to have mesh placed transvaginally for the repair of prolapse, we will discuss other treatment options with you.
If you have had pelvic organ prolapse surgery but don’t recall if mesh was used, please call our office at (425) 899-5800.
Midurethral Sling
Urethral sling surgeries to treat urinary incontinence involve placing a sling around the urethra to lift it back into a normal position and to exert pressure on the urethra to aid urine retention.
