Interviewer: Tell us how the mesh can contract and in itself pull tissues that could cause compression. Is that a mechanism of injury?
Interviewer: Yeah, so mesh does not necessarily have to go through the nerve. I think if it’s in a close proximity on the nerve it puts tractions on the surrounding tissues, which put pressure on the nerve. I also think that the mesh may cause just general inflammation of the tissue and bleeding in the area that may scar the nerve.
Interviewer: Tell us about the pain during sexual intercourse. What are the mechanisms of that?
Interviewer: So pain during sexual intercourse, also called dyspareunia, can come from many different conditions. Probably the most common cause of pain with sexual intercourse is the spasm of the pelvic floor muscles. So the vagina is surrounded by pelvic floor muscles, mainly levator, obturator muscles. So during sexual intercourse those muscles are stretched, so if those muscles are in spasm and pain to begin with, they hurt even more during intercourse.
Interviewer: There are cases where patients actually develop worse incontinence after mesh, and it could be either the overactive bladder type of incontinence, which is the urge incontinence, or overflow incontinence. When the mesh is placed too tight and the patient can’t empty her bladder, her bladder gets so full at some point that it just starts leaking, so that’s the overflow type