Mesh erosion: what it is and the symptoms to know

Mesh erosion happens when transvaginal mesh or a bladder sling wears through the vaginal wall or into a nearby organ such as the bladder or bowel. Commonly reported signs include vaginal pain, bleeding, unusual discharge, pain during sex, a partner feeling the mesh, and recurring urinary infections. Erosion can appear weeks or years after surgery.

Maybe you had surgery for pelvic organ prolapse or bladder leakage, and for a while things seemed fine. Then something changed. Pain that doesn't fit normal healing. Bleeding or discharge you can't explain. Pain during sex that wasn't there before.

Some women describe feeling something sharp or rough inside the vagina. For others, a partner notices it first. These are among the most common signs of mesh erosion, which the FDA identifies as the most commonly reported mesh-specific complication of prolapse surgery with mesh.

This guide explains what erosion is, what it can feel like, how it is diagnosed and treated, and how it connects to the mesh lawsuits.

What is mesh erosion?

Transvaginal mesh is a synthetic material, usually polypropylene, implanted through the vagina to support pelvic organs that have dropped out of place. A bladder sling is a narrow strip of similar mesh placed under the urethra to treat stress urinary incontinence, which is leakage when you cough, laugh, or lift something.

Erosion happens when the mesh wears through the tissue around it. Doctors use several overlapping terms for this. Exposure, extrusion, and protrusion usually describe mesh that has broken through the vaginal wall and can be seen or felt inside the vagina. Erosion is sometimes used the same way, and sometimes more narrowly for mesh that has worked its way into a nearby organ such as the bladder, urethra, or bowel.

Your medical records may use any of these words. What matters is that the record describes mesh where it shouldn't be.

What symptoms do women most often report?

Symptoms depend on where the mesh has moved. The ones women report most often involve the vagina:

• Vaginal pain that is constant or sharp, or that gets worse with sitting, walking, or exercise.
• Pain during sex, called dyspareunia, sometimes with bleeding afterward.
• A partner feeling the mesh during intercourse, often described as scratching or a sharp edge.
• Feeling the mesh yourself, a rough or wire-like texture inside the vagina.
• Bleeding or spotting that isn't explained by a period.
• Unusual or foul-smelling discharge, which can be a sign of infection.

When mesh erodes into the urinary tract, women more often report:

• Urinary tract infections that keep coming back.
• Blood in the urine.
• Pain or burning when urinating, or a frequent, urgent need to go.
• Trouble emptying the bladder completely.

Erosion into the bowel is less common. It can cause rectal pain, rectal bleeding, or changes in bowel habits.

Not every symptom on these lists means erosion, and some exposures cause no symptoms at all and are only found during a routine exam. A doctor's exam is the only way to know.

When can erosion appear?

Erosion can show up within weeks of surgery, but it can also appear years later. Many women had their implant long before they connected their symptoms to it. Some were told their pain was part of normal healing, or that their infections were unrelated.

That matters medically, because symptoms are worth raising with a doctor even if your surgery was a long time ago. It can also matter legally, because of how filing deadlines work, which is covered further down.

How is mesh erosion diagnosed?

It usually starts with a pelvic exam. A doctor can often see or feel exposed mesh in the vaginal wall.

When erosion into the bladder or urethra is suspected, a doctor may perform a cystoscopy, a procedure that uses a thin camera to look inside the bladder. Imaging such as ultrasound or MRI can help locate mesh that isn't visible during an exam.

If you are not getting clear answers, you can ask for a referral to a urogynecologist or urologist who treats mesh complications. Not every gynecologist sees these regularly.

How is it treated?

Small exposures without symptoms are sometimes just monitored, or treated with vaginal estrogen cream to help the tissue heal. Many women, though, need surgery to remove the exposed or eroded portion of the mesh. This is called revision or excision surgery.

Removal can be partial or complete. Mesh is designed to grow into the surrounding tissue, so full removal can be difficult, and some women need more than one procedure. Removal does not always resolve every symptom.

How does erosion connect to the mesh lawsuits?

Erosion is one of the central injuries in mesh litigation. Women who have filed claims allege that manufacturers knew or should have known about the risk of erosion and other complications and did not adequately warn patients and doctors. The manufacturers have disputed these claims.

The FDA's regulatory record is relevant background. In April 2019, the FDA ordered the remaining manufacturers of surgical mesh for transvaginal prolapse repair to stop selling those products in the United States. The agency later reported that required follow-up studies found women who received mesh for prolapse repair had a higher risk of mesh exposure and erosion than women whose repair used their own tissue. Bladder slings for stress urinary incontinence were not part of the 2019 order and remain on the market.

The large federal cases were once grouped into MDLs, short for multidistrict litigation, where similar federal lawsuits are consolidated before one judge. Those MDLs have closed. Individual claims continue in state courts, and attorneys are still reviewing new cases.

Who may qualify for a review?

Attorneys reviewing mesh claims typically look at a few things: whether you received transvaginal mesh or a bladder sling, whether you have been diagnosed with erosion, exposure, or a related complication, and what treatment followed, such as revision or removal surgery.

You don't need to know the answers to all of those before asking. A free review is how you find out whether your situation may fit.

What records help most?

• Your operative report from the original surgery, which usually names the device and manufacturer.
• Records of the erosion diagnosis, from the exam, cystoscopy, or imaging.
• Records of any revision or removal surgery, including pathology reports if the removed mesh was examined.
• A list of doctors and approximate dates for every visit related to your symptoms.

You don't need everything in hand to ask for a review. Hospitals and surgical centers provide records on request, and an attorney's office can often help obtain them.

Is there a deadline to file?

Every state sets a statute of limitations, which is the deadline for filing a personal injury claim. For injuries that appear years after surgery, many states start that clock when you discovered, or reasonably should have discovered, the injury and its connection to the device, rather than on the date of the implant. This is called the discovery rule, and how it applies varies by state.

Because your deadline depends on your state and on dates in your own records, it makes sense to ask once you have a diagnosis rather than waiting.

What if I'm worried about cost, privacy, or going to court?

Embarrassment keeps many women from asking about these injuries at all. The review is confidential, and the people who handle these claims discuss pelvic and sexual symptoms routinely and plainly.

Mesh claims are typically handled on contingency, which means the attorney is paid a percentage only if the case recovers money, and you pay nothing upfront. Most product liability cases resolve without the injured person testifying at trial, though every case is different.

What should I do now?

If you have symptoms, start with a doctor, and ask directly whether mesh erosion or exposure could explain them. Ask for copies of your operative report and any records that mention the mesh.

If you have already been diagnosed or have had revision surgery, a free review can tell you whether your situation may fit an active claim.

Disclaimer: This article is general information, not legal advice, and reading it does not create an attorney-client relationship. Injury Advocate Group is an advertising service, not a law firm. Litigation status changes; eligibility can only be confirmed through a case review with an attorney.