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Answer to your Health Question

Question (04/6/2011):

Title: Painful intercourse for my husband after cystocele repair .

My mesh in coming undone from having a Cystocele almost 3 years ago

It has never been right from the start, but I have no medical insurance since I lost my job.

Sex feels good to me, but not to my husband.

He feels the very sharp mesh and scar tissue from the sling.

What can we do to keep him from feeling pain?

Would condoms help?

As soon as he feels pain it is all done.

Valerie

Answer:

Dear Valerie,

Estrogen vaginal cream may help the stretching process.

Some doctors recommend using a vaginal dilator to help the process along and others recommend a repeat surgery.

Studies of:

Sentilhes L, Berthier A, Sergent F, Verspyck E, Descamps P, Marpeau L. Sexual function in women before and after transvaginal mesh placement for pelvic organ prolapse. International Urogynecology Journal and Pelvic Floor Dysfunction. 2008

And

Gauruder-Burmester A, Koutouzidou P, Tunn R. Effect of vaginal polypropylene mesh implants on sexual function. European Journal of Obstetrics Gynecology & Reproductive Biology. 2009

have shown that vaginal mesh does not seem to have a negative impact on sexual function , prospective comparative studies between mesh and traditional repairs in the anterior compartment have shown no significant difference in rates of dyspareunia , and one:

Nieminen K, Hiltunen R, Heiskanen E, et al. Symptom resolution and sexual function after anterior vaginal wall repair with or without polypropylene mesh. International Urogynecology Journal and Pelvic Floor Dysfunction. 2008

has actually shown a lower risk of dyspareunia in the mesh group .

Risk of dyspareunia or vaginal pain can be kept to a minimal by ensuring that the mesh lies flat in the space and is placed tension-free; that is, the mesh arms penetrating the sidewalls should not be pulled too tight or create a "band" as this can cause pain with or without intercourse.

Additionally, as graft technology continues to improve, a lighter, less dense type I mesh may also help reduce these risks even more.

Health professional should explain that mesh procedures for bladder prolapse (cystocele) is a recent development.

It involves the use of bio- synthetic mesh to provide additional support to the tissues during the repair.

The success rate of the procedure depends on the type of mesh used.

In a smaller percentage mesh erosion can happen after a few years with superficial erosion of the tissues and mesh being exposed through vaginal tissue or adjoining bladder and bowel.

Though they have an elastic component sometimes after tissue healing they can be embedded very tight and can give rise to denovo dyspareunia.

You can find more information related to your question at:

Painful intercourse after monarch sling surgery is something normal.

I feel the roughness of the mesh hammock with a digit, how will this affect sexual intercourse?



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