Interviewer: Tell us about the erosions. What is that? Where does it occur?
Interviewer: So erosion of – so the transvaginal mesh is placed immediately under the epithelium of the vagina, which is that outermost layer of the vagina. And normally that layer is closed over the mesh; it’s sutured over the mesh. But in some patients because of different factors, that mesh may actually eat through the epithelium of the vagina and cause an erosion, so it’s visible in the vagina.
Interviewer: Are there bladder erosions too?
Interviewer: Yes, it may erode to the other organs, but bladder erosions are probably you know much more less common than vaginal erosions. But yes of course it can erode into the urethra, into the bladder, into the bowel, and of course into the vagina.
Interviewer: Can you take care of those complications as well in your practice?
Interviewer: Absolutely.
Interviewer: Of course pain seems to be a predominant problem with this. Can you talk about the pain generators from the mesh?
Interviewer: Yeah, so I believe that patients that have pain that develop after mesh, it could be caused either by erosion, but again that’s fairly simple to address. Pain may also be from the spasm of the pelvic floor muscles that surround the mesh, and I think that’s probably the biggest group. And then the third group are the patients where the arms of the mesh are close to the nerves or nerve endings and they either physically damage the nerve by literally going through the nerve or they’re in the close proximity of the nerve endings and they basically pull on the area and cause pain.