There are a number of surgical procedures used to correct vaginal wall prolapse. Many of these use a material called mesh. Mesh may be made of natural (‘biological’) or synthetic materials, or a combination of both, and may be absorbable or non-absorbable.
Treating a vaginal wall prolapse with mesh is usually done under a general anaesthetic. The mesh is implanted to strengthen the weakened area and provide support for the vagina, restoring the affected pelvic organs to their natural position.
IMPORTANT UPDATE
Since July 2018, this procedure has been paused and safety measures are currently under review. Procedures using vaginally inserted tapes or meshes will not be offered unless there is no alternative and the procedure cannot be delayed.
If you have undergone the procedure to have mesh or tape vaginally inserted and you believe that you are experiencing complications, then you should contact your GP or surgeon for a follow up.
More information on why the procedure is under review can be found on the gov.uk website. This page details the surgery and complications that may be faced, for informational purposes.
Surgery
Most repair operations take about an hour and you may need to stay in hospital for three to five days, depending on the type of procedure that you have. With some newer techniques you may be able to go home on the same day as the procedure or on the following day.
During surgery, the mesh is inserted into the vagina either to support the sagging uterus or to prevent future prolapse of the vagina. The main mesh treatments are:
- Sacrohysteropexy, where one end of the mesh is attached to the cervix (entrance to the uterus) and the other to a bone in the spine to hold the uterus in place.
- Sacrocolpopexy, where one end of the mesh is attached to the top of the vagina to prevent the vagina collapsing. This is done at the same time as a hysterectomy.
- Infracoccygeal sacropexy, where the mesh is inserted through the buttocks and into the back of the vagina.
Surgery Complications
All types of surgery carry some risks. Your surgeon will be able to explain these in more detail, but possible complications could include:
- the mesh wearing away – further surgery may be required to remove and replace the mesh
- damage to the surrounding organs, such as your bladder
- an infection – you may be given antibiotics to take during and after surgery to reduce the risk of infection
- pain during sex
- vaginal discharge
- vaginal bleeding
- experiencing more prolapse symptoms – which may require further surgery
- a blood clot forming in one of your veins (for example, in your leg) – you may be given medication to help reduce this risk after surgery
Recovering from surgery
While you are in hospital, you may have a drip in your arm to provide fluids and a thin plastic tube called a catheter to drain urine from your bladder. Some gauze will be placed inside your vagina to act as a bandage for the first 24 hours. This may be slightly uncomfortable.
For the first few days after your operation you may have some vaginal bleeding which is similar to a period. You may also have some vaginal discharge. During this time you should use sanitary towels rather than tampons.
Recovering at home
The recovery time after surgery for prolapse of the uterus can take up to three months. If you find that activities make you tired, you may need to rest.
You should rest for around two weeks, but for the first 8-12 weeks you should:
- Avoid heavy lifting. You should not be carrying anything heavier than a two-litre bottle of water.
- Avoid doing any strenuous exercise. You may have been shown some exercises in hospital to help reduce your risk of blood clots and strengthen your pelvic floor muscles. You can carry on with these and go for gentle walks.
- Avoid standing up for long periods of time. Only do light housework, such as dusting. Do not do the vacuuming or carry heavy shopping.
- Avoid becoming constipated. Drink plenty of water, eat a high-fibre diet and use laxatives (medication) if necessary. Please click here for more information about treating constipation.
You can go swimming after three or four weeks if your vaginal discharge has stopped and you should be able to start having sex again after around six weeks, again if you’re vaginal discharge has stopped.
Reporting Issues
The NHS states that any adverse incident involving a device such as Vaginal Mesh should be reported to the MHRA, especially if the incident has led, or might have led to:
- deterioration in health or permanent impairment of body structure or function;
- the necessity for medical or surgical intervention (including implant revision);
- hospitalisation or prolongation of existing hospitalisation;
- death;
- life-threatening illness or injury.
Please visit https://yellowcard.mhra.gov.uk/ for more information on how to report serious issues relating to Vaginal Mesh Support, you may need to specify that your issue involves ‘surgical implant materials’ such as mesh or tapes.
Further Information
This treatment is under review. If you have undergone surgery and require clinical support, please visit your GP or healthcare professional as soon as possible.
For more information about complications and where in the UK you can get specialist support, see the NHS leaflet: Mesh Complications
