Transvaginal Mesh Implants and Procedures
When transvaginal mesh (TVM) kits were introduced in the 1990s, they were advertised as a quick and easy fix for the most uncomfortable and disruptive of female medical problems. TVM was aimed at repairing organ prolapses, which happen when muscles and ligaments loosen and the internal organs to bugle into the vagina, and the subsequent urinary incontinence.
TVM was born out of surgical mesh used for abdominal hernia repairs. The mesh is a woven plastic that is flexible enough to support fallen organs that include the bladder, uterus and bowels. The idea is that the mesh supports the organs so they can function properly. In the early years, doctors custom cut pieces of mesh and surgically implanting them through abdominal incisions.
Soon, medical device companies came out with TVM kits that included precut surgical mesh pieces and specialized equipment. With these kits came the transvaginal procedure. Instead of making several large incisions to insert the mesh through the abdomen, doctors inserted it through the vagina and one or two small groin incision.
Types of Transvaginal Mesh
Depending on the procedure needed, the severity of the prolapse and other factors, there are basic types of TVM devices that are used.
- Transvaginal Full-Length or Patch Slings – The full-length sling or patch slings are implanted through a several abdominal and vaginal incisions and secured using absorbable sutures. The full-length sling it typically large – about one-inch wide by about seven-inches long and the patch is much smaller at about one-inch wide by about two-inches long. The size of the device depends on the scope of the prolapse.
- Tension-free Transvaginal Tape (TVT) – Mainly used for the treatment of SUI, the mesh is inserted through the vagina and two small incisions in the lower abdomen near the pelvic bone. Unlike other TVM procedures, sutures and bone anchors are not required, but it does require the surgeon to blindly pass a needle through an area located above the public bone. This area, called the retropublic space, contains highly vascular tissues and is close to the bowel and bladder.
- Trans-Obturator Tape (TOT) – Following some serious complications from TVT procedures and the blind needle passage, surgeons created the TOT procedure. This procedure eliminates the need for the needle to go into the retropublic space. Instead, one needle is placed through the groin area. Doctors found this to have a decreased risk of internal injuries when compared to the TVT.
- Mini Slings – Also used for SUI, the mini-sling procedure only uses one incision, in the vaginal area under the urethra. Some doctors say this reduces the risk for injuries.
The organs involved in prolapse procedures are the bladder (cystocele), the uterus (procidentia), the rectum (rectocele), the top of the vagina (apical prolapse) and the bowel (enterocele). All of the pelvic organs can be involved as well, which is called a vaginal vault prolapse.
Legal Assistance for Transvaginal Mesh Procedures
Most, if not all, of the TVM devices that are on the market today are made from polypropylene, a petroleum-based flexible plastic, and coated with a bovine collagen. Research shows that this combination causes a inflammatory response in the body, causing the body’s own immune system to attack the mesh. The mesh breaks down, or erodes, into nearby tissue. It also shrinks, causing immense pain and bleeding.
Today, the largest manufacturers from all types of TVM products are facing litigation from women nationwide. There are six multidistrict litigations (MDLs) involving Johnson & Johnson’s Ethicon division, C.R. Bard, American Medical Systems, Boston Scientific, Coloplast and Mentor Corp.
For more information about your legal options, please contact our experts about your transvaginal mesh injuries.