Category Archives: Anatomy & Physiology

10 Facts of Life for the Pelvic Mesh Newbie

  1. Mesh injuries and illness rates are much higher than medical studies show. Most published research favorable to mesh is funded by the manufacturer.
  2. Mesh is mesh. There is no “old mesh.” It is all that same thing with minor changes in shape or route. Polypropylene is just plain damaging to human tissue.
  3. The pelvis is a perilous place to conduct surgery. Even human or pig mesh or simple suture repairs can cause problems–but not as frequently as pelvic mesh.
  4. Your new pelvic problem is very likely caused by the mesh itself. Fearing litigation and believing the manufacturer’s advertising, doctors are reluctant to blame the device.
  5. Some pain and infection get better with removal–but not all.

    KIM Mesh

  6. Very few surgeons know how to take mesh out, so they fake it with partial revision surgeries that lead to new complications and more surgeries. More surgeries = more scar tissue.
  7. There is no justice. There are almost no medical malpractice lawsuits anymore. There is no money in malpractice litigation for the lawyers since “Tort Reform” was enacted in all 50 states. Doctors and the AMA lobbied and paid for Tort Reform.
  8. About class actions, there is no money for a lawyer who represents a patient with pain, infection, nerve damage, etc. because recent settlements are based on the number of surgeries you’ve had and not how sick or injured you are.
  9. Don’t wait for legal recourse before finding a competent surgeon. Consider crowd-funding to get well.
  10. You shouldn’t have to do this alone. Join a mesh support group but keep a critical mind and don’t accept advice just because another person is adamant in their post Be careful. Be sure to double check any answers you receive. A good internet search can provide your best education.

 


Peggy Day is working on a book to combine all these stories. This is an excerpt from Pelvis in Flames: Your Pelvic Mesh Owner’s Guide. Your input is welcome to help make Pelvis in Flames the book you need to read.

If you’d like to join an online support group and learn about erosion, partial removals, surgeons, or just find out that you are not alone, check the list of support groups here.

Subscribe to PelvicMeshOwnersGuide.com to learn more about pelvic mesh. I’d like to hear from you if you are helped by what you read here or if you need to know more about any particular topic. Comment below or email me privately at daywriter1@gmail.com.

Pudendal Nerve Injury Caused by Improper Insertion of TOT Obturator Tape – Pelvic Pain

The two main nerve complications TOT-injured women report in support groups are 1) pudendal and 2) obturator in that order. Because most studies do not evaluate for nerve injuries past 3-12 months, there is no scientific estimate of how common the injury is. Our experience is that it is extremely common. Pudendal injury causes persistent pain localized around the urethra and around the clitoris, irradiating to the one labia majora (maximum at the lower edge of symphysis) or both.

Polypropylene creates cripples when placed inside the pelvis.

The pudendal nerve is nowhere near the pathway of an obturator tape so how did the women get injured? The mystery may have been solved by three Czech investigators.

In 2011, Jaromir Masata & Petr Hubka & Alois Martan decided to look into why their patient, a 48 years old female obtained a pudendal nerve injury. After receiving a TVT-O, the woman experienced what the authors saw as an “atypical” postoperative pain that continued without relief for three years. While the authors treated her with injections and replaced her sling with yet another dubious tape, the work they did to track down the cause of her injury is valuable.

Authors circled scar and placed a “+” pointing to correct placement location.

The woman’s insertion scar (see Figure 1) was in the wrong place. By using a cadaver to trace the aberrant passage of her sling, the researchers found it intersected with the pudendal nerve. How many others were injured this way? Are you one of them? Was your transobturator tape placed incorrectly? If the manufacturer provided short videos and an instruction sheet, was that adequate training for your surgeon?

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    • If you are helped by what you read here or if you need to know more about any particular topic, comment below or email me privately at

daywriter1@gmail.com

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What Does a Bladder Really Look Like? Pelvic Mesh Implants

The bladder and urethra play a key role in pelvic organ prolapse and stress urinary incontinence. The most frequent cause of SUI is early bladder prolapse.

Figure 1. Illustration from patent application 2004. “u” is called a urethra. “B” is called a bladder.

As we age, the bladder loses support from neighboring fascia, muscles, ligaments and tendons and drops down, folding itself over supporting structures underneath (and over slings or sutures after surgeries). The folding narrows the outlet or urethra. Imagine you are holding a rolled up throw rug under one arm to carry it, it folds over and the hole inside it narrows and flattens.

Figure 2. Offset oil funnel.

Mesh illustrations in journal articles, public information handouts, and patent applications are inaccurately show the urethra as a straw-shaped tube through which urine flows. See example in Figure 1. It is really a sideways funnel — “offset” like the photo of the oil funnel in Figure 2. Figure 3. is a healthy bladder.

Figure 3. Healthy non-prolapsing bladder.

How in the world did the patent office and the FDA clear this product, a mesh tape with wing-like extensions for treating female urinary incontinence US 8047982 B2, when the illustration clearly shows a tube and the device is designed to fit a straight tube?

It is no wonder patients become confused.

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    • If you are helped by what you read here or if you need to know more about any particular topic, comment below or email me privately at

daywriter1@gmail.com

    .

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Specialized MRI and 3D Ultrasound See Mesh – CT Can’t

Too many surgeons are sending patients to have a CT (Cat Scan) and,  when the radiologist says he/she can’t see mesh, tell the patient the mesh must have disappeared or dissolved when a CT cannot identify mesh. Plastic mesh does not dissolve. Sadly too many patients have their pain disrespected or disregarded when the problem is the doctor’s. Only specialized 3D Ultrasound with the right technician and radiologist (more on this coming in another blog soon) and specialized MRI’s with the skills to see it and read it can identify mesh.
Here is a graphic, courtesy of www.scbtmr.org that you can print out an take to your doctor.

MRI to find mesh

How to see mesh with an MRI

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Why Not Talk About Hernia Mesh?

I often hear that people think that there is too much attention paid to pelvic mesh victims at the cost to the hernia victims. After all, it’s the same material that is used, just cut in a different shape and placed in a different part of the body. And, truth is, pelvic organ prolapse is very similar to a hernia —both are caused by a weakening of muscles.

When I planned this blog, I decided to focus on one type of mesh because it is the one I know best and because I planned to go into depth with my research. In the back of my mind, I want to do another blog called the Hernia Mesh Owner’s Guide —some day.

POLY IS FOR CUTTERS

I hope hernia sufferers will look at the parts of this blog that apply to them because so many complications are the same: the denial by doctors, the nerve injuries, the salesmen in the operating room, the body’s foreign body reaction and the resulting autoimmune diseases, the cancer risk, the pain, loss of consortium, and the loss of ability to work. The great difficulties getting it removed are similar. Mesh shreds, twists, curls, folds, stretches, migrates, disintegrates, etc. no matter where it is placed.

In looking at why the two entities got separated in the first place, it is important to look at the history of several legal battles. Hernia mesh underwent similar legal attacks about 20 years ago. Many versions of hernia were removed, recalled, and quietly taken off the market. Many people sued and won and many lost. In the end, really, the makers won. They just changed a few elements of hernia mesh, paid for scientific studies that proved it was a great product, and went right on marketing it (the same thing is happening with transvaginal mesh).

So, when the makers found a new application for mesh, putting it into women’s most private, most valued and most delicate place, it cause NEW problems because of the anatomy of the pelvis. The lawyers, like chairs on a tipping ship, rushed to represent this new disaster and abandoned the hernia meshes because there is no longer any money in those cases.

Hernia mesh victims: please be aware that not a single victim made this separation; it was done by lawyers.

Sadly, there are probably no lawyers who represent hernia mesh victims unless it involves malpractice and even that is very hard to prove. BigPharma and the AMA put legislation in place long ago to limit the amount you can win. (Tort reform only benefits those entities). BigPharma also controls much of major media. Thank goodness for social media!

 

Peggy Day is working on a book to combine all these stories. She welcomes any input you may have.

If you’d like to join an online support group and learn about erosion, partial removals, surgeons, or just find out that you are not alone, check the list of support groups here.

Subscribe to PelvicMeshOwnersGuide.com to learn more about pelvic mesh. I’d like to hear from you if you are helped by what you read here or if you need to know more about any particular topic. Comment below or email me privately at daywriter1@gmail.com.




Pelvic Mesh Owner’s Guide to Inner Female Pelvic Anatomy –

Mother Nature wisely hid some pretty important organs in your pelvic basin—your uterus and vagina, bladder and—which are protected by your bones, muscles, joints, ligaments and tendons.
Moving: Muscles, Joints, Ligaments, and Tendons

The major job of your pelvic structure is allowing movement: walking, running, sitting, bending and kneeling. Your bones, muscles, tendons and ligaments do this job. Your pelvis is really a basin with three openings at the bottom. The front of the basin is made of three bones: the ishium (sit bone), ilium, and pubis, and the back consists of your lower spine: sacrum and coccyx, or tailbone. The socket for the top of your femur or leg bone reaches into your pelvis on either side and rides on a something called your acetabulum, a cup-like structure formed where your ischium, ilium, and pubis all meet. Your acetabulum allows you to move your body and moving your body is what keeps you healthy.
Joints are simply the place where two bones connect. They are constructed to allow movement and provide mechanical support. Joints can be fibrous (joined by dense regular, collagen fibers), joined by cartilage (translucent somewhat elastic tissue), or the joint may include a synovial cavity to cushion movement, like your hip joint. Your pelvis holds some of the most powerful ligaments in your body: including your symphysis pubis (front of your pelvis), sacroiliac (connects your sacrum and ilium), and sacrospinous (links each pelvic bone to your sacrum and coccyx and maintains the length of your vagina).pelvic landmarks
Without muscles, both your pelvic and belly contents would fall out. They hold your bladder, vagina, uterus and rectum and your abdominal contents in place. Your pelvic muscles will become important in this book when we discuss one of the major reasons for surgical pelvic mesh: pelvic organ prolapse. Three muscles working together, your puborectalis, pubococcygeus, and iliecoccygeus muscles, create your pelvic floor (perineum) and resist any additional pressure (like when you cough) to keep your urine and stool in check. Two thick membranes cover and protect your pelvic muscles and become important when surgery involves cutting them: your parietal (wall) layer and your visceral (internal organ) layer, which is closer to your abdominal organs.


Peggy Day is working on a book to combine all these stories. This is an excerpt from Pelvis in Flames: Your Pelvic Mesh Owner’s Guide. Your input is welcome to help make Pelvis in Flames the book you need to read.

Join our FORUM to continue learning about surgical mesh.

If you’d like to join an online support group and learn about erosion, partial removals, surgeons, or just find out that you are not alone, check the list of support groups here.

Subscribe to PelvicMeshOwnersGuide.com to learn more about pelvic mesh. I’d like to hear from you if you are helped by what you read here or if you need to know more about any particular topic. Comment below or email me privately at daywriter1@gmail.com.