Use of the laser after mesh surgery is a relative contraindication according to the user manual. However, I have treated patients with prior transvaginal mesh and attempted to laser in the areas that are mesh free. Knowing which mesh procedure was performed is crucial. If there is mesh exposure or erosion I would probably recomend dealing with that first. Also, the MonaLisa Touch is safe after mid urethral slings.
The presence of vaginal mesh is a relative contradiction to the use of MLT. This means that the mesh may be a reason to avoid the laser treatments, but it depends on several factors. Was the mesh used for the correction of urinary incontinence? If so, this narrow sling of mesh placed beneath the urethra will not be effected by the treatments. If large pieces of mesh were used for a reconstructive vaginal procedure and if it lies deep beneath the vaginal lining, the MLT should be perfectly safe. Only if the mesh is exposed within the vagina or if it is very shallow under the vaginal lining would there be a concern about the MLT treatments. In summary, your doctor should be able to determine if the mesh poses a problem with respect to MLT treatments.
The user manuals for both the Mona Lisa Touch and FemiLift CO2 laser devices both state that lasers should not be fired into the areas with mesh. They don't provide a reason or any data to support this statement and there have been no studies done to see what does or doesn't happen to women who have a laser fired into the area of the mesh. It is simply a cautionary statement to protect these companies from legal exposure if a woman developed a mesh problem after having these procedures. I would be comfortable treating the non-mesh areas of the vagina because the skin overlying the mesh would be unaffected.
Great question. You can definitely have the laser after a mesh procedure, provided that there is no mesh exposure, near mesh exposure, or infection. A doctor who is very familiar with mesh procedures should examine you and then determine if you are a good candidate. The manufacturer calls it a "relative" contraindication, so it just depends. I hope that helps!
MonaLisaTouch can be done with gossamer-like mesh supporting the bladder neck as in "trans-obturator tape(TOT)" or "trans-vaginal tape (TVT)". Major mesh support of the top and bottom walls of the vagina preclude the use of the laser energy, probably for fear of producing an erosion of the mesh through the thin vaginal lining. Perhaps more information will be available in the future.
Reconstructive pelvic organ prolapse surgery with a "mesh kit" is considered a contraindication for the Mona Lisa Touch. However, you still may undergo treatment with prior placement of mesh used during intra-abdominal pelvic organ prolapse procedures. Simple stress urinary incontinence procedures using mesh are not a contraindication.