Vaginal Mesh – Controversy and Truths

Presented at the AORN of Twin Cities Fall Workshop, November 4th, 2017 By Dr. Michael Ehlert
Article written by Leah VanGorp and Jane Oksnevad

Dr. Michael Ehlert is a Female Pelvic Medicine and Reconstructive Surgeon with Metro Urology. He spoke on the difference between mesh for prolapsed bladder versus slings for urinary incontinence. According to Dr. Ehlert, when mesh was used for prolapse, a high percentage of women continued to have symptoms because of the lack of training for the surgeons in its use and the problem was more a lateral defect and not getting fixed properly. There were many cases of mesh erosion until 2011 when the FDA issued a warning about vaginal mesh and many companies pulled it from  the market.

Slings were excluded from the 2011 warning and have become the standard of care for urinary incontinence. The FDA stated “Safety and effectiveness of multi-incision slings is well established in clinic trials.” Prolapses are treated in a variety of ways, including standard tissue repair, abdominal mesh (usually done laparoscopically without a vaginal incision), or tissue graft like fascia latte or vaginal mesh. Incontinence is typically treated with a TVT/sling or fascia latte for failure or high-risk. Dr. Ehlert was a very engaging speaker and enjoyable to listen to.