Your physician can help you determine the best option for treatment from among these common approaches:

Monitoring
For small defects, your physician may recommend a “wait and see” approach, to see if your condition stabilizes or progresses.

Estrogen Therapy
Also for small defects, your physician may prescribe an estrogen cream for you to apply directly to the defect.

Mesh Removal
Removal of the synthetic mesh is generally recommended for patients who are experiencing recurrent erosion, have had radiation treatment, or have sepsis, large defects, a severe infection, or intense chronic pain.

Mesh removal is usually done through the vagina rather than through the abdomen. It might be done in the physician’s office or at the hospital. Sometimes it is not possible to remove all of the mesh. Multiple operations may be necessary. Removal can be challenging because the mesh isn’t visible under magnetic resonance imaging (MRI), computed tomography scan (CT scan) or X-ray. It is important that you seek out a doctor with experience in mesh removal.

Vaginal Wall Restoration
Once the eroding mesh has been removed, the defect in the vaginal wall needs to be closed. If it is small, the surgeon might simply close it with sutures. However, to avoid narrowing or shortening the vagina, the surgeon might decide to use a patch or graft to cover a gap and reinforce the repair. Cook Medical has developed a biologic graft for this type of tissue repair:

• Biodesign Vaginal Erosion Repair Graft: This advanced tissue repair graft communicates with the body, signaling surrounding tissue to grow across the graft, allowing the body to restore itself. Biodesign is not prone to erosion. It also helps minimize risk of infection, completely remodels into your own tissue, provides long-term strength and is a natural material. Biodesign provides a permanent repair without a permanent material.