Can Pelvic Mesh Be Seen On Ultrasound?
Imaging techniques such as pelvic floor ultrasound or MRI is becoming more common in urogynecology. One of the primary uses is the evaluation of synthetic vaginal mesh implants. Most such implants are clear on ultrasound but are not apparent using conventional imaging methods, making pelvic floor ultrasound especially helpful for this purpose.
Following the international success of polypropylene sling mid-urethral slings, which were developed in the late 1990s, the pelvic mesh was introduced in 2003-2004. The widespread use of surgical mesh for stress urinary incontinence and pelvic organ prolapse repair has increased mesh-related problems, negative publicity, and lawsuits, with numerous products withdrawn from the market. It is not unexpected that there is an increase in demand for imaging-based testing and evaluation of sling and vaginal mesh complications and implants.
What is Pelvic Mesh?
Pelvic mesh or transvaginal mesh (TVM) is a medical device surgeons surgically implant in women to treat Pelvic Organ Prolapse (POP) and female Stress Urinary Incontinence (SUI). POP usually occurs when the pelvic organs sink and bulge due to a weakening in the vaginal wall.
SUI, on the other hand, is a pelvic floor dysfunction characterized by a lack of bladder control and discomfort. These pelvic floor disorders may develop as a woman matures after a hysterectomy, childbirth, or an accident. Pelvic mesh is stretched across the posterior vaginal wall prolapse or pelvic floor during surgery to support injured organs and tissues. This kind of mesh is also known as surgical mesh or transvaginal mesh.
Why is pelvic mesh used?
In women, the pelvic mesh may repair pelvic organ prolapse (POP) with a tension-free vaginal tape and treat stress urinary incontinence (SUI).
The pelvic mesh is usually inserted permanently to strengthen the anterior vaginal wall for POP repair or to support the urethra or bladder neck for SUI repair.
Pelvic mesh is used in three major surgical treatments:
1. Transvaginal mesh repair to treat POP.
2. Mesh inserted transabdominally to treat POP.
3. SUI treatment using a mesh sling: Three incisions (cuts) may be made during a multi-incision sling surgery. Two tiny incisions are made above your pubic bone, and another incision is made in your vagina during the mesh surgery. The transobturator surgery is done by two small incisions in the thigh and groin area and also in the vagina. A mini-sling procedure, which involves inserting a shorter piece of surgical mesh, needs just one incision.
POP may also be treated without the use of surgical vaginal mesh repair. In such a situation, the incisions are typically done in the vagina, and just sutures are used to seal them. Mesh sling surgeries have been effective in the majority of patients and in around 70% to 80% of cases within one year after surgery.
SUI may also be treated surgically without the use of synthetic mesh. The surgeon may harvest a portion of your own muscle fascia or tissue to create a sling to restore bladder and urethral support. In such a situation, your tissue may be extracted from your abdominal muscles through a C-section incision or an inner thigh incision.
Can pelvic mesh be seen on ultrasound?
Many women with a transvaginal mesh insert wonder, can ultrasound show any transvaginal mesh complications yet? Yes.
Not only does real-time ultrasound imaging enable dynamic evaluation and clinical examination of pelvic floor functional anatomy, but it is also the preferred way for visualizing current urogynecological implants such as MUSs and pelvic meshes.
Ultrasound imaging facilitates the identification of women with levator avulsion who are most likely to benefit from vaginal mesh contraction or usage in areas where the vaginal mesh is still utilized. In patients with no sling placement or mesh placement, ultrasound may supplement patient history by confirming the existence of a synthetic implant, detecting an implant in a woman uninformed of the prior surgery, or clearing up ambiguities about the type of previous surgery.
Ultrasound imaging also aids in the detection and surgical treatment of some mesh surgery complications and POP recurrence, as well as in optimizing patient counseling and surgical reintervention planning. With more public awareness, increased litigation, and increased demand for mesh removal surgery, ultrasounds offer a low-cost, non-invasive imaging technology to help diagnose and provide patient care.
Does prolapse show on ultrasound?
A doctor will obtain a medical history and do a regular pelvic exam to identify pelvic organ prolapse. The pelvic exam may then be repeated while you are standing. This is sometimes all required to establish whether an organ has moved and, if so, which one. Other tests may be performed to detect whether more than one organ has shifted out of position, to evaluate the degree of the prolapse, and to look for urinary disorders induced by pelvic organ prolapse surgery, such as incontinence.
Suppose your symptoms suggest that more than one organ has moved out of position. In that case, your doctor may arrange an ultrasound test to capture pictures of the pelvis using sound waves. Ultrasound also assists your doctor in determining the severity of the prolapse.
Can pelvic mesh be seen on an MRI?
MRI (Magnetic Resonance Imaging) may be valuable in assessing and managing patients with mesh implantation issues. MRI may identify more severe infections than what is clinically evident in the outpatient environment.
Polypropylene mesh implants and trans obturator tapes are more difficult to detect than abdominal implants.
Pelvic Floor Prolapse recurrence
Female pelvic organ prolapse (POP) is a prevalent disorder with a high recurrence incidence after pelvic floor reconstructive surgery, and the risk factors for POP recurrence remain unknown. The most challenging issue in pelvic surgery is recurrent female pelvic floor organ prolapse after surgical repair.
Recurrent difficulties account for over 30% of all pelvic organ prolapse surgeries in the United States. Regardless of the introduction of new and “better” surgical instruments and methods, astonishingly, little is understood about the variables that prevent or encourage its occurrence.
In a study conducted From March 1999 to April 2006, the medical records of 212 patients who had conventional restorative, reconstructive operations for symptomatic pelvic organ prolapse were reviewed retrospectively. According to the Pelvic Organ Prolapse Quantification method, recurrence was defined as any prolapse of stage II or more.
Patients with a severely advanced preoperative stage (stage IV), particularly those with anterior prolapse, are more likely to have a recurrence following routine pelvic reconstructive surgery.
Please see your doctor if you have any complications associated with female pelvic reconstructive surgery. You can also seek compensation by hiring an experienced product liability lawyer, such as Thomas Plouff.