0042-84501407673I. APM232-06-Tomaszewski. Outcome of vaginal mesh reconstructive surgery in multiparous compared with grand multiparous women: Retrospective long-term follow-up. Abstract We aimed to compare the long-term surgical outcome and complications of multiparous and grand multiparous women undergoing reconstructive surgery with vaginal mesh implants for repair of pelvic organ prolapse.
This retrospective, long-term follow-up (28.17±20.7 months) comprised 113 women who underwent surgical reconstructive surgery with vaginal polypropylene mesh in a high parity rate population medical center. The women were divided into 2 groups (multiparous and grand multiparous) and each group was evaluated for objective and subjective surgical outcome. Patient demographics and surgical data were retrieved from electronic medical records. Outcome measure included POP-Q exam as objective outcome and validated Pelvic Floor Distress Inventory questionnaire (PFDI) to assess subjective outcome. Editor: RK Lee, UNITED STATES Received: July 9, 2016; Accepted: April 16, 2017; Published: May 4, 2017 Copyright: © 2017 Levy et al.
Introduction. In Vivo Ultrasound Characteristics of Vaginal Mesh Kit Complications. Transvaginal Mesh Kits-How "Serious" Are the Complications and Are They Reversible? To mesh or not to mesh: a review of pelvic organ reconstructive surgery. Management of Mesh Complications after SUI and POP Repair: Review and Analysis of the Current Literature. Transvaginal mesh: let's not repeat the mistakes of the past - Mowat - 2017 - Australian and New Zealand Journal of Obstetrics and Gynaecology. Over the last decade the premature introduction of transvaginal meshes for the surgical treatment of pelvic organ prolapse has had a negative impact on women who have experienced unexpected suffering and morbidity.
The resulting litigation has seen the voluntary removal of most of these products from the market and several international regulatory bodies, including the Food and Drug Administration (FDA), the Medicines and Healthcare Products Regulatory Agency, the Scientific Committee on Emerging and Newly Identified Health Risks, (a committee that advises the European Commission), an Independent Scottish review committee and the New Zealand Accident Compensation Corporation, issuing cautions regarding use of transvaginal mesh for the management of pelvic organ prolapse. Do we need meshes in pelvic floor reconstruction? Vaginal reconstructive surgery: A case for and against mesh use. The case for mesh use By Vincent Lucente, MD, MBA, and Carlos Roberts, MD Dr.
Zipper Urogynecology Associates. If you are reading this from somewhere on planet Earth, you are aware of the newspaper, radio, and television ads notifying you about the vaginal mesh litigation.
Here is the condensed version of what happened and what is currently happening: Synthetic materials in the form of sheets have been used for decades to repair abdominal hernias. Approximately fifteen years ago gynecologists and urologists began to use the most common hernia mesh material, polypropylene, in the treatment of vaginal hernias, also known as Pelvic Organ Prolapse (POP). The general thinking was that this synthetic material would provide a more durable treatment.
Realizing that a growing number of expert pelvic surgeons were implanting mesh to treat POP, Medical device companies did some simple math. They multiplied the number of patients undergoing Pelvic Organ Prolapse surgeries being performed each year (by non-experts) by the profit per piece of mesh. Mesh doesn't up cure rate for vaginal prolapse repair. Native tissue is superior to vaginal mesh for prolapse repair, two studies report : OBG Management.
From UNC at Chapel Hill: The use of mesh for anterior prolapse is associated with long-term increased risk of any repeat surgery—especially mesh-removal surgery.
From the Mayo Clinic: Natural tissue repair should be the procedure of choice for most women undergoing vaginal prolapse repair. April 2013 · Vol. 25, No. 4 Deborah RealeManaging Editor Have you read recent articles in OBG Management about the surgical use of mesh? Click here to access the list. Prd ctrb094968. Joint Recommendations Issued on Use of Vaginal Mesh for POP - ACOG. Washington, DC -- Due to concerns about the safety and efficacy of synthetic mesh placed vaginally for the treatment of pelvic organ prolapse (POP), its use should be reserved for high-risk women for whom the benefit may justify the risk, according to The American College of Obstetricians and Gynecologists (The College) and the American Urogynecologic Society (AUGS).
In a joint Committee Opinion issued today, the groups also say there is an urgent need for the development of a national registry to track outcomes for all current and future patients who receive vaginal mesh implants. The uterus, bladder, urethra, small intestine, rectum, and top of the vagina are held in place by the pelvic floor muscles and connective tissues. “When these muscles become torn or stretched, pelvic organs can drop down and bulge into the vagina causing pelvic organ prolapse,” said Cheryl B. Iglesia, MD, former chair of The College’s Committee on Gynecologic Practice. Co513. Innovations in mesh kits: elevate 2010. Consider alternatives to risky transvaginal mesh. It seems like every day there is a lawsuit for some form of medical product.
Lately, if you have noticed, many lawyers are now advertising and soliciting for individuals who have had a transvaginal mesh implanted. Before we talk about the complications of a transvaginal mesh, let's first understand what a mesh is and its intended use. A mesh is defined as a barrier. It looks like a fishing net and is usually made of either metal, fiber or plastic. Meshes were first used in the late 1950s for hernia repairs. Approximately 20 years later, surgeons, specifically gynecologists, started to use meshes to treat specific gynecological problems. In the 1970s, doctors started placing a mesh in females to keep the pelvic organs from protruding through the vagina. In 2008, the Food and Drug Administration took notice and reported about an increased number of adverse events most likely due to transvaginal placement of mesh.
Some options are the ones that many doctors have been preaching for years. Pelvic Organic Prolapse Procedures With Mesh Increase, Leading to Age-based Complications. Despite FDA warnings that a synthetic mesh used to treat a weakening of the female pelvis's walls can cause infection, pain, and disease recurrence, surgeons are increasing their use of the device.
What's more, when compared to not using mesh, younger patients who undergo surgery with mesh for pelvic organ prolapse (POP) are more likely to have a repeat surgery the following year, and older patients are more likely to have complications while they're in the hospital, according to new research from Weill Cornell Medical College. POP occurs when a woman's uterus or vaginal walls weaken and descend, causing bleeding, incontinence and other painful symptoms. The condition affects about 40 percent of women after childbirth, according to a 2002 study in the American Journal of Obstetrics and Gynecology. This study is the first to investigate mesh use in POP surgeries on a major population level like New York State and to employ such an extensive data set. FVVinObGyn-3-VII-IX. Vaginal Mesh Kits Pelvic Organ Prolapse Friend or Foe (Scientific World).pdf. J.1447-0756.2008.00820.x. Vaginal prolapse repair surgery augmented by ultra lightweight titanium coated polypropylene mesh.
Transvaginal Mesh Linked to Higher Bleeding, Infection Rates: Presented at ICS. By Nancy A.
Melville MONTREAL -- October 9, 2015 -- The use of transvaginal mesh in vaginal pelvic reconstruction shows an increased risk of perioperative bleeding and surgical site infection, compared with no mesh, according to data presented here on October 8 at the 2015 Annual Meeting of the International Continence Society (ICS). “The current study identifies bleeding and surgical site infection as early complications in vaginal pelvic reconstructive surgeries that occur more frequently when mesh is used,” said Majid Mirzazadeh, MD, Wake Forest University School of Medicine, Winston-Salem, North Carolina. In an effort to better understand differences in morbidity following vaginal reconstruction, the researchers evaluated surgical data on multiple vaginal procedures from the National Surgical Quality Improvement Program (NSQIP) between 2010 and 2012.
Procedures included anterior and posterior colporrhaphy, paravaginal defect repair, enterocele repair, and colpopexy. Indications, Contraindications, and Complications of Mesh in Surgical Treatment of Pelvic Organ Prolapse. Scheltes. What You Need to Know About Vaginal Mesh for Female Pelvic Surgery.