For years, doctors have told women with vaginal mesh complications that the pain is in their head. Emerging research confirms the pain is in the pelvis and is a real physical response to their vaginal mesh.
Few studies have focused on the body’s response to a vaginal mesh implant. This research from McGee Women’s Hospital at the University of Pittsburgh found the body elicits an autoimmune inflammatory response to the placement of vaginal mesh as the body fights the perceived foreign invader.
Twenty-seven women underwent mesh removal or excision due to pain or mesh exposure or erosion into the vagina. The explanted mesh was compared to 30 vaginal biopsy specimens from women who did not have a vaginal mesh implant.
Researchers found the excised vaginal mesh had higher levels of macrophages, a type of white blood cell that responds to a foreign body. An M1 is a macrophage that is proinflammatory leading to chronic inflammation and a ultimately a potential for tissue damage. A M2 macrophage remodels tissue which, if it is ongoing, can result in fibrosis and encapsulating of the mesh.
Fibrosis is essentially scar tissue formation that causes mesh to harden, become rigid and entrap nerves. Fibrosis causes chronic inflammation and that in turn can result in the vaginal mesh shrinking up to 50 percent.
Mesh removed because it was eroding into the vagina had an 88.4% greater response and higher number of macrophages and vaginal mesh degradation. Mesh removed because of pain had a higher number of M2 cells and was consistent with fibrosis.
This bodily response can go on for years, researchers discovered. The study is published in the August 2016 issue of the American Journal of Obstetrics & Gynecology.
None of these discoveries about vaginal mesh were made prior to it being approved for market because mesh manufactures were not required by the U.S. Food and Drug Administration to do any clinical trials. Instead vaginal mesh was allowed to be put on the market to treat pelvic organ prolapse or stress urinary incontinence with abundant marketing promises and no research to back it up. Doctors and marketers considered accurate placement of the mesh all that was necessary to call it a success.
We are now discovering 20 years later, that the permanent implants may elicit a permanent complication, even when they are removed or partially removed.
Doctors who listened to the mesh manufacturers and wrote off vaginal mesh complications as imagined pain did no service to their patients as they continued to implant vaginal mesh with a reckless disregard for their patient’s well-being.