PATIENTS MAY PRESENT WITH ANY OF THE FOLLOWING SYMPTOMS:
• Early postoperative vaginal discharge of old blood
• Irregular vaginal bleeding or discharge, particularly if the patient has had a hysterectomy
• Faecal discharge from vagina
• Intermittent rectal bleeding
• Discomfort during intercourse
• Palpable mesh
• Pelvic pain or swelling
• Recurrent or new bladder (recurrent infection) and bowel symptoms (recurrent ODS or faecal urgency)
• Intolerable back pain or leg pain (sciatica)
These symptoms are more likely to be mesh-related if there was recognised damage to the bladder, urethra or bowels during the original mesh procedure.
If a problem with a mesh device is suspected then the patient will need to be physically examined for any of the following signs of a mesh related problem.
• Tenderness on palpating the mesh
• Swollen recto-vaginal septum
• Graft / mesh exposure (erosion) into the vagina
• Graft / mesh exposure (erosion) into the rectum
• Mesh erosion into the bladder (very rare)
• Failure of the procedure and recurrence of prolapse
Any adverse incident involving a device should be reported to the MHRA, especially if the incident has led, or might have led to: deterioration in health or permanent impairment of body structure or function; the necessity for medical or surgical intervention (including implant revision); hospitalisation or prolongation of existing hospitalisation; death; life-threatening illness or injury.
PATIENTS WITH MESH COMPLICATIONS WILL REQUIRE REFERRAL TO A SPECIALIST TEAM EXPERIENCED IN REMOVING LVMR MESH.
These units are self-selected and this list will be updated by The Pelvic Floor Society with the development of unit accreditation.
• St Mark’s
Work is underway to commission mesh complication services through NHS England specialised commissioning.