Surgery and Repairs
When trying to alleviate the difficulty from stress urinary incontinence (SUI) or a painful pelvic organ prolapse (POP), many women turn to pelvic mesh surgery. Originally, the idea was that the mesh device was supposed to support sagging and fallen internal organs and alleviate the chronic pain and pressure. Instead, what women are getting is defective products that not only cause more pain but also doesn’t fix the POP or SUI problems.
When introduced in 1996, pelvic mesh was promised to be an excellent fix for POP and SUI, which plague women who have gone through childbirth, menopause, a hysterectomy or any stress that causes the pelvic muscles to loosen. Today, a growing number of these patients are facing the long-lasting consequences of a medical device gone wrong.
Pelvic Mesh Types
There are a variety of shapes and sizes of pelvic mesh, also called transvaginal or vaginal mesh, used to repair female pelvic problems. The type of device used depends on the condition.
SUI and POP devices
- Tension-Free Transvaginal Tape (TVT) -- This mesh is inserted through the vagina and two small incisions near the pelvic bone. The surgeon must blindly pass a large needle through a space near the pelvic bone, called the retropubic space. Used primarily in SUI.
- Mini-Sling -- The mesh is passed through the vagina into the pelvic area through a single incision. The mesh is placed under the urethra. Used primarily in SUI.
- Transvaginal Sling -- This full-length sling is implanted through the vaginal canal and is able to hoist prolapsed internal organs.
- Trans-Obturator Tape (TOT) -- Like the TVT, a TOT is a sling used to hoist fallen organs. The difference is that there is no needle passed through the retropubic space.
Pelvic Mesh Surgery
For pelvic mesh surgery, doctors must pass the mesh device through the vaginal canal and incisions in the vaginal wall for placement inside the body. Despite pretreatment with antibiotics and sterilization of the vagina, the mesh becomes covered with the body’s natural bacteria. Once placed internally, the body’s immune system launches an attack, causing the mesh to rapidly deteriorate. At the same time, the surrounding tissue becomes intertwined with the mesh. The pieces of mesh also shrink, causing sharp and chronic pains.
Some physicians are also finding a systematic illness as a result of the release of polymers in the body from the polypropylene mesh device. Called Implant Syndrome, symptoms include anemia, fatigue, exacerbated allergic reactions, muscle and joint aches and pains and heightened chemical sensitivity.
In 2008, when the U.S. Food and Drug Administration (FDA) started looking into the problems , the agency originally said they were rare. Three years later, the agency reversed its decision and ordered a wide-ranging review of pelvic mesh devices. The agency later said that pelvic mesh does not repair POP or SUI problems.
Pelvic Mesh Repairs
As a result of the pain and problematic immune response, most physicians attempt to remove the device through repeated surgeries, called revision surgeries. When they do, they quickly realize that eroded mesh is difficult, at best, to remove. Some of the pieces of mesh have deteriorated to microscopic sizes and become intertwined with tissue.
Best Pelvic Mesh Revision Surgeons
Only a few doctors, called urogynecologists, have mastered the skill of mesh removal. Even for them, the process can take several surgical procedures.
|Doctor||Medical Facilities”||Important Facts|
|Dr. Shlomo Raz||UCLA School of Medicine||Recently said complication rates are underreported. Patients travel worldwide for a Raz revision surgical procedure.|
|Dr. Christian O. Twiss||University of Arizona division of urology||Has said erosion could be caused by surgeon error. Trained under Raz|
|Dr. Philipe Zimmern||University of Texas Southwestern Medical Center||In 2007, long before the problems with pelvic mesh became well documented, Zimmern alerted colleagues to the dangers. He also trained under Raz.|
For all women who are in need of revision surgery, the best place to start is with a skilled urogynecologists. Regular gynecologists or urologist are not skilled at caring for a woman’s special needs.