Some women who have a TVT or TVT-O inserted for incontinence or prolapse experience mesh erosion into the vagina. The Martius Graft or Martius pad graft is used to treat such mesh erosion. The results ware not great and many women have complications from the graft and from the area the graft is taken from.
With recurrent mesh exposure, unresponsive to vaginal resuturing, the options a responsible body of urologists/gynaecologists would consider are either: excise the exposed portion of mesh or all of the peri-urethral / vaginal mesh can be excised.
A Martius Graft brings a graft of labial fat across from the labia majora to the vagina. The Martius flap is the technique of taking the labia majora for the repair tissue. It is used to minimise urethral-vaginal fistula risk after urethral surgery.
It is not commonly recognised as a method of managing vaginal mesh exposure.
The graft can cause:
Once the tape is exposed within the vagina it becomes chronically infected which can make healing a problem. Putting a graft on exposed and infected tape has unproven efficacy.
In addition, a Doctor’s duty of care included a duty to warn the patient that:
Women were not properly counselled or consented to the Martius Graft procedure. They were not given the choice of treatment nor told it could recur leading to more surgery. Failure to warn about the risks and complications when offering a Martius Graft for mesh exposure is substandard care.
If you have been advised to have a Martius Graft and it resulted in any of the complications listed then get in touch with Dr Victoria Handley today on 0800 470 2009 or email firstname.lastname@example.org