Surgical mesh, made from polymers or biological material, is used to repair pelvic organ prolapse and stress urinary incontinence in women. Possible complications include erosion, infections, and tearing of organs.
Surgical mesh is a screen-like material that is used as a reinforcement for tissue or bone. It can be made of synthetic polymers or biopolymers.
Materials used for surgical mesh include:
Most surgical mesh devices used for female pelvic reconstructive surgery are made of non-absorbable synthetic polypropylene.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Surgical mesh may be used to help repair pelvic organ prolapse (POP) and stress urinary incontinence (SUI) in women.
In pelvic organ prolapse, the pelvic organs may shift downward and bulge out of the vagina. This occurs in women whose pelvic floor muscles and tissue are too weak to hold the organs in place.
Pelvic organs that may be subject to a prolapse include the bladder, uterus, rectum, vagina and urethra. Factors that can increase the chance of POP in women include pregnancy, childbirth and aging. The bladder is most often involved in pelvic organ prolapse. Prolapse of the bladder is called cystocele.
In stress urinary incontinence certain activities that increase pressure on the abdomen can cause urine to leak. These activities can include coughing, laughing, sneezing or exercising. The weakening of the pelvic muscles and tissues causes the bladder neck to move downward. As with pelvic organ prolapse, factors such as pregnancy, childbirth and aging may cause the pelvic muscles to stretch or weaken.
Surgical mesh can be permanently implanted to reinforce the vaginal wall for POP repair, or support the urethra or bladder neck for the repair of SUI.
There are three main surgical procedures performed using surgical mesh:
POP can also be repaired without surgical mesh. In that case, the incisions are usually made in the vagina, and they are closed with sutures only. Surgeries in which mesh slings are used have been successful in most cases and in about 70% to 80% of cases within one year following surgery.
SUI may also be surgically treated without surgical mesh. The surgeon can harvest a piece of your own muscle fascia to use in the shape of a sling to reestablish support of the bladder and urethra. In that case, fascia may be taken from your abdominal muscles through a C-section “bikini” incision, or from your leg muscles with an incision on the inner thigh.
About 300,000 women in the United States underwent surgery to repair POP in 2010. Surgical mesh was used in about one out of three procedures. About 250,000 women in the U.S. underwent surgery to repair SUI in 2010, with mesh placement being used in over 80% of the procedures. The mesh sling has been the most widely studied procedure for stress incontinence in the history of stress incontinence surgery. All of the major urologic and gynecologic societies in the U.S. have supported its continued use as of 2019.
Surgery may be needed to remove the mesh or correct other complications as they can occur at times after mesh placement, although the overall incidence is rare. Over 50% of women who experienced erosion with non-absorbable synthetic mesh needed to have the mesh surgically removed. Some patients required two or more operations after the mesh was removed.
It’s important to know that the risks related to surgical mesh are different with various mesh-based repairs:
Negative effects following surgery can be life-changing for some women. Pain may persist even after the mesh is removed.
Consider various options regarding POP treatment, including non-surgical methods and suture-based methods that don’t use mesh, as they have been shown to be very effective in the long term without some of the complications associated with mesh use.
Surgery may be performed with or without the use of surgical mesh. Use of mesh may increase the risk of subsequent surgeries due to complications involving the mesh. In a small percentage of patients, additional surgeries might not solve all medical problems. However, surgical treatment with mesh may offer a more durable repair of the prolapse than non-mesh surgeries. Consult a specialist in this area as experience does help in determining the best course of management.
You should follow up with routine check-ups and pelvic examinations each year. Let your healthcare provider know if you have symptoms such as vaginal bleeding or discharge, pelvic or groin pain, or pain during sexual intercourse. Tell your doctor about any surgical mesh implants if you plan to have surgery to treat a related condition or another type of operation. Talk to your provider if you have any questions or concerns.
Last reviewed by a Cleveland Clinic medical professional on 09/30/2020.
Learn more about our editorial process.