Respect and Protect the Pelvic Floor

This month, the FDA issued an advisory warning against the use of mesh implants that are routinely used for transvaginal surgical repairs of women’s pelvic floor damage.

Tens of thousands of women opt for surgery each year to correct prolapses of the uterus and surrounding organs caused by damaged pelvic floors–which, to put it bluntly, can feel “as if something is falling out of your vagina.”

On a recent episode of his TV show, Dr. Oz shared the estimate that “almost half of [women] will experience some form of prolapse in [their] lifetime.” Cigna says the top risk factors are full-term pregnancies (which stretch the pelvic floor), the strain of childbirth and hysterectomies.

Many of these surgeries use mesh implant devices to support damaged pelvic floor tissue. The problem is that the mesh devices are harming women’s sexual and reproductive health.

The FDA advisory came in a response to increasing reports of complications stemming from the devices, including “pain and urinary problems,” as well as “erosion, when the skin breaks and the device protrudes, and contraction of the mesh that leads to vaginal shrinkage,” reports the Los Angeles Times. Back in 2008, the FDA’s Public Health Notification and Additional Patient Information documents cited 1,000+ reports of these kinds of serious complications but considered them to be rare. Fast forward to 2011 when these serious complications “have jumped fivefold”–no longer rare.

So, how do these complications impact a woman’s sex life? The FDA notes, “Both mesh erosion and mesh contraction may lead to severe pelvic pain, painful sexual intercourse or an inability to engage in sexual intercourse.” Male sex partners are also at risk: “Men may experience irritation and pain to the penis during sexual intercourse when the mesh is exposed.”

While the FDA issued an advisory, it stopped short of removing the mesh implants from the market. Did they do enough to protect patients? Some experts say no. Dr. Diana Zuckerman of the National Research Center for Women & Families points out that these mesh implants have been used, “despite no clinical trials, no testing on humans to see if they’re actually safe and effective.”

It is time to advocate strongly for research and development of pelvic floor surgical repair techniques that do not involve the use of synthetic mesh implants.

Adapted from a post at Girl w/ Pen, where the author has an ongoing column called Bedside Manners.

Image from the 1918 edition of Gray’s Anatomy.