Posted On: April 6, 2012 by Anapol Schwartz

Difference between transvaginal mesh, slings/tapes

Which of these medical devices is causing you problems?

That would depend on which procedure you had to correct what problem. For instance, if you had surgery to correct pelvic organ prolapse (POP) – then your doctor would have used transvaginal mesh, also called a graft. If you had surgery to correct stress urinary incontinence (SUI) your doctor would have used a sling or tape.

However, for some reason, the catch all phrase transvaginal mesh has been deemed the culprit.

The mesh resembles a panty-liner in size and shape but is made from porous material to provide support for prolapse. The sling or tape is thinner, shorter, like a mini hammock to support the urethra. Transvaginal mesh is a more invasive surgery than a sling or tape.

Manufacturers of both these implants include Boston Scientific, CR Bard, AMS, Ethicon/Gynecare, just to name a few.

There are three techniques for sling placement -- transobturator, suprapubic, and
pubovaginal. What are the differences?

Transobturator and suprapubic (also known as retropublic) slings are fixationless or tension-free (ToT) slings. Fixationless means they are held in place through natural tissue ingrowth rather than screws or sutures. These slings are made from synthetic material shaped like a U or hammock also known as subfascial hammock.

The transobturator technique is the newer technique involving a slight modification where the surgeon makes a vaginal incision but the sling arms are not passed between the public bone and the bladder which lessens the risk of urethral and bladder injury. Instead the needle enters next to the labia and is threaded under the urethra. The needle site is sealed with skin glue.

For the suprapublic technique, a small incision is made inside the vagina just under the urethra, and then two small openings are made above the pubic bone. These openings are just large enough for a needle to pass through. The surgeon uses a needle which holds the sling to place the sling inside the body. The vaginal incision is closed with a few absorbable stitches and the needle sites may be sealed with skin glue or sutures.

The pubovaginal procedure involves placing a band of sling material directly under the bladder neck or mid-urethra, which acts as a physical support to prevent bladder neck and urethral descent during physical activity. The sling also may augment the resting urethral closure pressure with increases in intra-abdominal pressure. Historically, surgeons have used the rectus fascia pubovaginal sling for complex SUI after a failed anti-incontinence operation.

If you are suffering from serious, ongoing, and painful side effects from either transvaginal mesh or sling/tape surgery – please contact an unsafe medical device lawyer to determine if you have a case going forward for pain and suffering and to cover medical expenses. You are not alone as transvaginal mesh lawsuit victims are reaching out for assistance.