Changed women: the long-term impact of vaginal mesh complications.
OBJECTIVE
The aim of this study was to describe how women experience vaginal mesh complications after optimized tertiary care level treatment.


METHODS
We conducted telephone interviews in 2012 with women at least 6 months after presentation to our tertiary care clinic between 2006 and 2011 for complications related to vaginal mesh and transcribed verbatim responses to 2 open-ended questions about their experiences surrounding vaginal mesh complications. We analyzed data using qualitative description with low-inference interpretation in a team-based setting followed by consensus meetings to arrive at descriptive trajectories of their experiences.


RESULTS
Of 111 women, we successfully contacted 88, and 84 agreed to the interview. The mean duration from index mesh surgery to interview was 4.5 years, and the mean duration from presentation to our clinic for complications to the interview was 2.3 years. The effects of mesh complications caused both physical and emotional pain, in addition to the discomfort of the original pelvic floor dysfunction. The women's experiences followed 1 of 3 recovery trajectories. In "cascading health problems," the women experienced a spiral of health problems, anxiety, and desperation. In "settling for a new normal," the women who once considered themselves healthy now believed that they are unhealthy and worked to adjust to their degraded health status. In "returning to health," the women described a return to health. The women still symptomatic discharged from tertiary care clinic expressed hopelessness and abandonment.


CONCLUSIONS
Concomitant with ongoing research to improve the safety of vaginal mesh procedures, there must be dedicated efforts to develop and study a range of therapies for holistically treating women with mesh complications.
From the *Department of Obstetrics and Gynecology, and †Department of Family and Preventative Medicine, University of Utah School of Medicine, Salt Lake City, UT; and ‡College of Nursing, University of Utah, Salt Lake City, UT.
Guinn Ellen
GE
Dunn
Brooke L
BL
Hansen
Marlene J
MJ
Egger
Ingrid
I
Nygaard
Ana C
AC
Sanchez-Birkhead
Yvonne
Y
Hsu
Lauren
L
Clark
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004414:Dyspareunia / Q000209:etiology; D005260:Female; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D056887:Pelvic Organ Prolapse / Q000523:psychology / Q000601:surgery; D017699:Pelvic Pain / Q000209:etiology; D011788:Quality of Life; D012086:Reoperation / Q000523:psychology; D012649:Self Concept; D053825:Suburethral Slings / Q000009:adverse effects; D013526:Surgical Mesh / Q000009:adverse effects*; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000523:psychology / Q000601:surgery