You will notice that none of these flows lead to a “happy ending” and hardly any suggest full pelvic mesh removal. Pelvic mesh implants are designed for fast and permanent implantation. This allows more surgeries to be performed per surgeon per day making it very profitable for surgeon, hospital and mesh manufacturer. Implantation is often “blind” meaning the surgeon cannot see where the large implantation needles (trochars) are going. This blind invasive implantation through the heavily occupied space of the pelvis carries risks of injury during implantation (e.g. bladder or bowel perforation) as well as the risk of mesh-based complications following surgery. During the design of mesh devices, thought was given to fast implantation methods, however, no consideration was given to removal.
If you follow the various flows in these charts, you will see many suggest division or partial removal. Many women who undergo division or partial removal of pelvic mesh will have repeat surgeries due to continuing issues. With so few studies exploring the outcomes of pelvic mesh removal, it’s hard to know what to expect.
In my case, I decided not to have a division or partial removal, even though I knew that full pelvic mesh removal would leave me completely incontinent. The decision to have mesh removed (like the decision to have it implanted) is not to be taken lightly. Having only one mesh made my decision easier. My pain stopped the very day the mesh was removed. Unfortunately this is not true for everyone. Let’s explore the 18 considerations that I believe are key if you are planning pelvic mesh removal.