Your bladder, and other pelvic organs are supported by the muscles, ligaments and connective tissue of the pelvic floor.
These supportive tissues can become stretched or weakened by childbirth or surgery, or by chronic strain such as heavy lifting.
When a pelvic organ, such as the bladder, uterus or rectum, loses it’s support it can drop from it’s normal position. This is called "pelvic organ prolapse".
Surgical mesh is sometimes used to support a pelvic organ that has become prolapsed. When the bladder has prolapsed, or a cystocele has formed, stress urinary incontinence can occur.
In surgery, when the mesh is placed inside the body via an incision made in the wall of the vagina, it is called "transvaginal mesh" (transvaginal = through the vagina).
Serious complications can occur from transvaginal mesh. Mesh can erode through the vaginal or bladder wall causing severe pain, infection and bleeding. Additional surgery may be needed to treat injury or remove the mesh. Complete removal may not be possible. The FDA has issued an advisory, and transvaginal mesh lawsuits have been initiated.
In this illustration transvaginal mesh has been placed in between the anterior wall of the vagina and the back of the bladder. The "arms" of this particular type of mesh are sewn to the pelvic floor muscles and fascia. This creates a sling like support of the posterior bladder wall and neck, preventing it from prolapsing back and downward, and bulging into the vagina.
The more anterior "arms" of the mesh are attached via a transobturator surgical approach. The obturator foramen is an opening in the pelvic bone.