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This review aims to understand the sexual and relational impacts of transvaginal mesh injury reported by women.

June 26, 2026Open Access

An exploration of sexual and relational impacts of transvaginal mesh injury: a systematic review using thematic synthesis

Key Points

This review aims to understand the sexual and relational impacts of transvaginal mesh injury reported by women.
Systematic search of five databases and grey literature in April 2026.
Included reports on women's experiences of mesh injury with a focus on sexual and relational impacts.
Data was thematically synthesized, and the quality of studies was assessed using the qualitative CASP checklist.
Nine reports included with a total of 1483 participants, reflecting a heterogenous evidence base.
Seven themes identified: changes in sexual functioning, relationship satisfaction, identity, and roles due to pain.
Chronic pain from mesh injury significantly disrupts sexual and relational aspects of women's lives.

Abstract

BACKGROUND: Transvaginal mesh, used to treat Pelvic Organ Prolapse and Stress Urinary Incontinence, has caused substantial injury to a growing number of women. The impact of mesh injury is far-reaching, significantly disrupting women's lives. Whilst there is a growing body of literature examining the impacts, there is little research that specifically aims to understand the sexual and relational implications of mesh injury. This study aimed to systematically review evidence regarding the impacts of mesh injury reported by women in relation to sexual and relational functioning. METHODS: A systematic search of five databases (CINAHL, MEDLINE, PubMed, PsycINFO, and ProQuest Dissertations and Theses) and a grey literature search was conducted in April 2026. Studies and inquiries reporting data about women's experiences of mesh injury where sexual and relational impacts were reported were included. The quality of each study was assessed using the qualitative CASP checklist. The data was thematically synthesised. RESULTS: A total of nine reports were included, comprising of six published studies, one unpublished Doctoral thesis, and two government inquiries. Sample sizes were varied, with individual study sample sizes ranging from 7-84, and a secondary analysis of 399 accounts from one study. Participants included in government inquiries ranged between 517 and 555. A conservative total of 1483 participants is represented, reflecting the heterogeneity of the evidence base and limitations in the reporting of inquiry data. Of the nine included reports, eight were rated high quality with one rated as moderate. Seven overlapping themes were developed from the data: 1) Sexual functioning: changes due to pain, 2) Changes to sexuality, 3) Relational activity: changes due to pain, 4) Changes to relationship satisfaction, 5) Identity: changing sense of self navigating life with mesh injury, 6) Changes in relational roles and a seventh central theme of disrupted embodied sexual-relational self. CONCLUSION: Women with mesh injury experience significant sexual and relational disruption as a result of chronic pain, contributing to psychological distress. Psychological flexibility may be a protective mechanism for relational distress. Further research that seeks to understand these impacts is needed, which may inform the development of appropriate psychological interventions. TRIAL REGISTRATION: PROSPERO ID: CRD420251077730.

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