When things go wrong: experiences of vaginal mesh complications

Abstract

Introduction Previous research has suggested that complications stemming from vaginal mesh can lead to life-changing negative physical consequences including erosion and chronic pain. However, there has been little research on the experiences of women who have had complications. This study was aimed at exploring the individual experiences of women who have had vaginal mesh complications and how this has impacted them. Methods An explorative qualitative design was followed. Eighteen semi-structured interviews were conducted with women who had experienced complications with vaginal mesh due to stress urinary incontinence and pelvic organ prolapse. The mean age was 52 and the mean time since the mesh was fitted was 8 years (6 had since had it removed and a further 6 had had partial removal), and the mean time since first mesh-related symptom was 10 months. Data were analysed using thematic analysis. Results Four main themes were identified: perceived impact of mesh complications, attitudes of medical professionals, social support and positive growth. Results showed that participant experiences of their mesh complication were psychologically traumatic, including feelings of increased anxiety and fears relating to suicidal thoughts. Intimate relationships were also affected, with reduced sexual functioning and intimacy stemming from mesh complications. Negative experiences with medical professionals included feeling dismissed, a lack of recognition of their symptoms, and anger towards the profession. Conclusions The impacts of vaginal mesh complications were found to be wide-reaching and life-changing, affecting numerous aspects of participants’ lives. Greater awareness in this area is needed to provide further support for women experiencing vaginal mesh complications.

Pain and other complications of pelvic mesh: a systematic review of qualitative studies and thematic synthesis of women’s accounts

“… 36 Participant numbers varied from 7 to 752, with a total across the 9 studies approaching (and possibly exceeding) 2000. Four studies were recruited from patient populations exclusively 27 31 33 34 and one partially 32 ; four from advocacy groups for affected women, two exclusively 30 35 and two partially 16 32 ; and two drew on material from national enquiries. 16 36 Where non-patient participants such as carers and clinicians also provided material for the report, 16 36 we used only submissions from affected women or representatives of mesh advocacy groups.…”

“…Only three provided information on ethnicity, all majority or entirely white (European, non-Hispanic), 27 32 34 but it is likely that the other studies were similar in this respect. Four studies were recruited from clinical populations 27 31 33 34 and one partially so 32 ; two through social media support groups 30 35 ; and two issued open invitations to contribute to national inquiries. 16 36 As far as could be ascertained, two studies recruited women with mesh still in place, 31 35 and the remainder recruited a mix of women with mesh in place, mesh partially removed, mesh fully removed or having had unspecified revision surgery.…”

“…Some of the comments about positive experience were apparently spontaneous, but others were elicited by leading questions. 30 …”

“…31 It should be noted that the conflicts of interest for this latter study disclose that three of the eight authors had associations with mesh producers. Two studies 34 36 combined deductive and inductive approaches; four were inductive, 27 31 32 35 one implied an inductive approach but some themes rather closely resembled question topics, 30 one simply described 'low level inference' in its analysis 33 and the inquiry 16 took a transparent approach to reporting but did no formal qualitative analysis. Two studies 27 32 and one inquiry 16 discussed and revised their findings with the help of participants.…”

“…Some of the comments about positive experience were apparently spontaneous, but others were elicited by leading questions. 30 Review by women with experience of mesh Seven women with complications of mesh took part in the online meeting, plus another who facilitated the meeting arrangements and transcribed the meeting content. Some of the women had undergone mesh removal and others had not; for most, symptoms persisted or had worsened.…”