Transvaginal Mesh Erodes Into Bowel and Causes Septicemia

This case involves a sixty-eight-year-old woman who presented to her gynecologist complaining of vaginal prolapse. The physician recommended that the patient should undergo surgery because he claimed no other conservative methods would work on her condition. The patient underwent a laparoscopic hysterectomy along with a vaginal mesh implantation procedure that was conducted without incident. Less than three months after the procedure, the patient presented to the emergency room with severe abdominal pain that was greatly out of proportion to her physical exam. It was determined that the mesh invaded into the patient’s bowel and caused a perforation. The patient was extremely septic upon her arrival at the hospital and died during surgery to repair the damage. The cause of death was due to a hypotensive episode that could not be managed intraoperatively, secondary to septic shock.

Question(s) For Expert Witness

How safe are the use of vaginal mesh devices, and are there concerns in the medical community about complications?

Expert Witness Response E-001236

On July 13, 2011, the FDA issued a statement that serious complications are not rare with the use of surgical mesh in transvaginal repair of pelvic organ prolapse. The FDA reviewed the literature from 1996-2011 to evaluate safety and effectiveness and found that surgical mesh in the transvaginal repair of pelvic organ prolapse does not improve symptoms or quality of life more than nonmesh repair. The review found that the most common complication was erosion of the mesh through the vagina, which can take multiple surgeries to repair and can be debilitating in some women. Mesh contraction was also reported, which causes vaginal shortening, tightening, and pain.