Category Archives: Dehiscence

26 Pelvic Mesh Complications Your Doc Never Mentioned

Welcome to the Pelvic Mesh Owner’s Guide! This page is like a Table of Contents.

Over 4.2 million women have the implants and a quarter to a third of them suffer debilitating complications while doctors say, “It’s not the mesh.” The FDA warned in both 2008 and 2011 that complications are serious. Too many women are finding out they were right all along, it is the mesh. 

If you’re having trouble with mesh, here is a list of 26 complications in the Pelvic Mesh Owner’s Guide. Sign up for updates to learn more and take the first step on your healing journey.

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26 Mesh Complications Your Doctor Never Warned You About:

1) Intractable Pain (pain that doesn’t go away) – Some people wake up from implant surgery knowing something is wrong. It is too tight or the pain is beyond measuring. Part 1 talks about the post operative pain from pelvic mesh & Part 2 is one woman’s journey with pelvic mesh pain.

2) Excessive BleedingBleeding happens but when is it too much? When to call the doctor? How to regain strength after heavy bleeding

3) Urinary tract infection, Kidney infection – Urinary tract infections are serious health-risks and can involve the bladder and kidney. When mesh is stuck in the bladder it continually irritates the bladder until it is removed surgically. Learn how to prevent UTIs and test yourself at home and to distinguish a bladder infection from a kidney infection.

     4) Wound infectionsA bladder sling can act like a petri dish harboring and incubating strong, sometimes drug-resistant bacteria. Left undiagnosed, they can lead to a delay in wound healing, even open up wide and deep surgical wounds and putting your life at risk.

5) Bladder injuryA slip of the knife, a puncture from an ice-pick like trocar, sling pulled so tight that it cuts the bladder. A bladder injury is one of the most difficult to repair. One study says it happens 10% of the time, another say 75%!

6) Bowel InjuryWhen a part of the bowel is nicked, fecal matter seeps into the interior of the body, when it the diagnosis is delayed or completely missed, patients become extremely ill.

7) Fistula (a hole between two organs) – Imagine your urine draining out of your vagina or your stool coming out. Fistula is all to common and deeply embarrassing for women.

8) Wound Opening Up After Stitches(also called dehiscence) – You think your surgery is healing and you are trying to get back on your feet and back to normal. Then your wound starts to open up. Dehiscence delays healing for a very long time.

9) Erosion – (also called exposure, extrusion or protrusion) As many as one patient in three experiences erosion from mesh. Would you agree to mesh if you were told the odds that you wouldn’t enjoy sex ever again were one in three?

10) Incontinence “I sneeze, I pee.”The odds that mesh surgery won’t cure your incontinence is the same as other surgical repairs: one in three.

11) Urinary Retention “I can’t pee right.”A mesh that is implanted too tight can slow down or stop your urine stream for about four percent of patients. Why does your surgeons “handedness” (right- or left-handed) affect your outcome?

12) Dyspareunia – pain during sexual intercourse One study found 26% of women found sex too painful after mesh surgery.

13) Multiple surgeriesWhen things go wrong, often the solution is another surgery and another. Some women have had over a dozen surgeries to correct mesh complications. More surgery = more scarring.

14) Vaginal scarring/shrinkage – Vaginal scarring: one of the most emotionally and physically difficult problems to heal.

15) Emotional DamageNaturally, an injury to a woman’s re-creative center causes emotional pain but can we allow doctors to blame the women?

16) Neuro-muscular problems – nerve damageStinging, burning, pins-and-needles, numbness all are signs of nerve damage. Even the way your body was positioned during surgery can cause nerve damage.

17) Obturator Nerve – Symptoms in your mid-thighs (saddle region).

18) Ilioinguinal/iliohypogastric Nerve – Symptoms in your pubic region.

19) Genitofemoral Nerve – Symptoms in your inner groin.

20) Femoral Nerve – Symptoms in your outer thighs

21) Pudendal Nerve Entrapment – Symptoms in your “sit spot.”

22) Fibular Neuropathy – Symptoms on the outside lower legs

23) Saphenous Nerve – Symptoms on your inner lower legs

24) Piriformis Syndrome – Symptoms across your buttocks.

25) Sciatica – Symptoms all the way down your leg.

26) Peripheral Neuropathy – Symptoms from the bottom of your feet and up your legs, even your hands can be involved.

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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.

Signing Up For Just One Surgery With Pelvic Mesh?

Imagine this: Two women had tree branches fall across their homes causing major damage. Both trees did the most damage to the kitchen. Cindy Lu hires the guys who promises to get the job done the fastest for the least money. Her contractor comes in one day, and chops out the middle of the branch and cleans up the mess on her kitchen floor and replaces her kitchen faucet so it will run. He gets the job done in less than a day. Karen hires a more experienced contractor who takes out the entire branch and repairs all her plumbing, appliances and replaces her furniture and cleans up every tiny piece of bark or wood chip. It takes several days. He comes back later on and fixes the broken walls, windows and doors and returns her home to as close to pre-storm conditions as possible.

Which contractor would you hire?

This is an analogy to what happens when pelvic mesh goes bad. The surgeon who chips away at pelvic mesh, one eroded bit at a time, sets up a patient for multiple surgeries— today’s mesh trouble. Recently, Linda Gross won over 11 million dollars at trial after 18 surgeries to repair erosion, scarring, and tissue damage from a Gynecare Prolift pelvic sling. Surgeries performed after the pelvic mesh implant correct erosion, new or continued incontinence, difficulty urinating, infections, scar tissue, pain, deheisance, or fistulae. Women experiencing generalized symptoms they attribute to mesh opt for removals as well and report an improvement in their symptoms.

MESH IS FOR LAUNDRY

Synthetic surgical pelvic mesh was first thought to be faster, easier and better than traditional repairs like culpopexy and porcine and native tissue sling repairs. Newer research says it  just wasn’t true.  In a 2013 review, authors concluded that, even though sacral colpopexy had a longer operation time: “the sacral colpopexy had a higher success rate on examination and lower reoperation rate than high vaginal uterosacral suspension and transvaginal polypropylene mesh.”

Mesh removal is risky business due its faulty design. Absent-minded scientists have been accused of not stepping back and looking at the “big picture” ever since Thales, the Greek mathematician, looked up at the stars so often that he fell down a well. Designers of pelvic mesh imagined they found the best thing since the flat turret lathe or bifocal eyeglasses. It was so perfect, they must have thought, nobody would ever want to remove it.

It is an interesting observation that more doctors are prone to diagnose only what they can see—on your body, an x-ray, in a lab report then by the patient’s description of her problems. Headaches, backaches and now pelvic pain are the least recognized and treated medical complaints today. Until the “BLUE sh*t” (as Johnson & Johnson execs called Gynecare mesh in a secret email) could actually be seen by the doctors, women’s complaints were ignored. If they got an answer from their doctors, they were advised to have it snipped, dissected, ligated, trimmed or revised. When the mesh kept sneaking back, surgeons removed more little bits.

It takes a highly skilled surgeon like Dr. Shlomo Raz at UCLA to remove all of the mesh, including the anchors (secured ends).  The few surgeons who do remove the mesh in its entirety complain that removing all of shards of mesh from healthy human flesh is like getting bubblegum out of hair.

Dr. Dionysios Veronikis of St. Louis, MO invented a surgical instrument that  dissects the mesh away from the healthy tissue without cutting surrounding structures. He finds one end of the mesh and then carefully cuts, moving his instrument forward until it frees up the entire sling in one piece. It is hours and hours of painstaking work and healing from the procedure takes a long time.

Once mesh is removed, more surgeries are often needed to revise the damage left behind and fix structural problems. Complications, like bleeding, infection, and nerve damage, from mesh removal surgery are common. After finally going through removal surgery, 87% said they would never have had the artificial mesh implant in the first place, if they had only known. If you’ve not yet had an implant, you are one of the lucky ones because, now that there is more research and information is available on the net–mesh does not appear to be easier or better. Many, if not most, doctors are reverting to traditional fixes. You can save yourself a boatload of trouble by finding a surgeon who can repair your problem without 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 MeshTroubles.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.

Why Wound Infection After Pelvic Surgery Is So Much Worse

Besides holding your healing process back, a surgical wound infection can make you very sick, disfigure you, create fistulas require more procedures and surgeries or make a mess of your plans for the future. Synthetic surgical mesh intensifies your risk of infection after surgery because it drags bacteria into the deep recesses of your body and then acts like an over-generous host, allowing several difficult and stubborn types of bacteria to grow and multiply on its surface. Manufacturers have adamant about changing the mesh composition rather than finding a more natural and less toxic remedy for SUI (stress urinary incontinence) and POP (pelvic organ prolapse).

A surgical site infection is a nosocomial infection (hospital-acquired) that can occur within 30 days after surgery. Mesh-related infections, the most common complication after mesh surgery, cause “significant morbidity,” which, in plain English, means it makes you sick, very sick and for a long time. Nosocomial infections come under careful scrutiny by the State and Federal agencies. Over 3 million people have mesh inside their bodies and many of them want it taken out. However, the danger of stirring up the “germ soup” surrounding mesh implants should be considered before planning pelvic mesh removal surgeries.
While wound infection is a complicated topic, today blog offers an overview and links to a few articles about pelvic infections from established medical journals. You are welcome to print them and take to your doctor.

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Cause: The environment in your vagina is different from the what’s on your skin—where most surgeries begin. Even when the cut is made abdominally, through your skin, for transvaginal mesh surgeries, the connection with your vagina is made inside your body. That makes you more vulnerable to the kinds of bacteria that like to live inside your vagina. Some vaginal bacteria hate light and love warmth so when they get pushed inside the deep pelvic spaces they continue to thrive and cause trouble. They form a bacterial wall called a biofilm on the surface of the mesh where the body’s natural defenses can’t reach. There are often several different bacteria causing a post-op pelvic infection, and these may include: gram-negative bacilli, enterococci, group B streptococci, and anaerobes.  (More on those in a later blog.)

Types of pelvic surgical site infections: The three most common post-operative pelvic infections are vaginal cuff cellulitis, pelvic cellulitis, and pelvic abscesses. The infections, in order of severity, can be superficial, deep, or within the organ space.

A superficial infection, vaginal cuff cellulitis, involves the skin and subcutaneous tissue (just under the skin). You may feel pain or tenderness, localized swelling, redness, or heat over the area. Deep infections, pelvic cellulitis, involve the fascia, muscle, etc. You may have thick, yellow or brown drainage the wound, a spontaneously dehiscence or your surgeon may deliberately open your wound to allow drainage, fever over 100.4F (>38°C) degrees, pain in the surgical area, or tenderness. Lastly, you may  have a deep abscess, pelvic abscess, requiring drainage. Infections involving organs and spaces around organs produce purulent (containing pus) drainage from a surgical drain, abscess, and include the signs of infection above.

Tests used to identify the extent of the infection include a thorough examination by your surgeon, or radiological exams like ultrasound, CT (computerized tomography), MRI (magnetic resonance imaging), or exploratory surgery. Your surgeon will probably take a culture of the wound to find out which bacteria is causing the infection and to prescribe the right antibiotic(s).

Risk Factors: You may be at greater risk of developing a post-op infection if you have diabetes, especially if your blood sugar goes over 150 mg/dL just before and after surgery or your hemoglobin is over 6.5% just before surgery. Other risk factors include obesity, (BMI> 30), anemia, prior strokes, tobacco, steroid use (like prednisone), malnutrition, increased age, prior radiation treatment to the site, or vaginal infection. The longer you are in the hospital before your surgery, the higher your risk for post operative infection.

Let your doctor know if you’ve had any recent bacterial infections. When you minimize your risk factors, you lessen your chance of getting a post-op infection.

Pre-op antibiotics: Before the invention of a process of giving pre-op prophylactic antibiotics, as many as 33 percent of patients ended up with pelvic infections. After prophylactic antibiotics were introduced, the number of infections dropped to 2.7%. Before pelvic surgery, ask your surgeon what is the plan for your antibiotic prophylaxis.
The most common prophylaxis follows the American Journal of Health-System Pharmacy recommendations: Cefazolin be given within an hour before or hour after the first incision. If the surgery goes longer than 3 hours, they repeated doses. Larger doses to be given to women over 265 pounds (120 kilograms). Chart of antibiotic guidelines here: Table 1  and Table 2  If you are allergic or resistant to one antibiotic, other ones can be given. Table 3 is a list of recommended antibiotics for pelvic mesh surgery infections separated by depth of infection.

If you are suffering from a pelvic surgical infection, take gentle care of yourself. Plan to rest, and take plenty of non-caffeinated, low- or no-sugar fluids. Eat the foods your mother made you finish: fruits and vegetables, proteins. Take multiple vitamins. Gather around you your most nurturing friends and relatives and send any annoying visits out to run errands. There are several support groups you can join to gather encouragement as you go through the long and slow process of of healing. May it be rapid.

We’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 at daywriter1@gmail.com.
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Dehiscence – Why Did My Wound Open Up?

Looking down on your surgical wound and seeing it open up is one of the most disturbing and traumatic experiences a human can go through. You certainly had an expectation that your wound would heal. The experience is extremely frightening.

A dehiscence is a reopened wound that has come apart at the “seams.” The cause may be a wound infection, a wound injury, poor wound healing, or failure of the whatever material was used to close the wound (sutures, staples, etc).
The risk of dehiscence is usually with the first two weeks after surgery. A large wound dehiscence requires immediate attention should be reported to your surgeon as soon as possible. Abdominal wounds that dehisce can result in organs protruding from the abdomen. If that happens, place sterile dressings over the wound, do not strain, get help and call your surgeon. If your surgeon is not available, don’t hesitate to call 9-1-1. An ambulance has the proper sterile dressings available and can help you move while avoiding straining.

The edges of the wound that are separating may have redness or swelling, drainage or even tissue coming from the wound. Some risk factors for dehiscence include abdominal surgery, exertion after surgery, diabetes, obesity, HIV infection and the presence of synthetic surgical mesh. Mesh is a factor because bacteria like to congregate near the surface of the implant. (See Wound Infection Complication)

Normal wounds heal from the outside in but dehisced wounds heal from the inside out and take much longer to heal—but they do heal eventually with good care. Treatment includes gauze packings, frequent dressing changes, and resting the area affected. Every other stitch might be removed to allow for better drainage. If drainage does not get out, it can create a tunnel through the affected area as it tries to surface and drain. (Surgeons often place rubber or plastic drains while the would is beginning to heal to help it find the surface.) Large wounds are packed with sterile dressing which is changed routinely, often by a wound care specialist or nurse. The wound may be cultured and antibiotics, tylenol or non steroidal anti-inflammatory medications may be prescribed. Occasionally, the wound is repaired surgically.

Dietary changes may be recommended in order to build up your body’s ability to fight infection and a physical therapist may visit to help you return to normal activities as soon as possible. The best thing you can do for your body is to take plenty of fluids and rest, giving it a chance to heal.

MESH IS FOR Sprouting

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.

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12 Pelvic Mesh Common Complications That Should Make You Think Twice

Plastics and human flesh, what could possibly go wrong? Ever since the day you had mesh implanted, you’ve had no end of troubles but your doctor says, “It’s not mesh related.”

Severe and life-threatening mesh complications are more frequent and widespread than doctors realize. Here are a dozen mesh problems that women have reported to the FDA:

    1.    Excessive Bleeding
    2.    Infections:    
            ⁃    Urinary tract infection, Kidney infection
            ⁃    Wound infections
    3.    Organ perforation
            ⁃    Bladder injury
            ⁃    Bowel Injury
            ⁃    Fistula (a hole between two organs)
    4.    Wound Opening Up After Stitches –  (also called dehiscence)
    5.    Erosion – (also called exposure, extrusion or protrusion)
    6.    Bladder problems:
            ⁃    Incontinence “I sneeze, I pee.”
            ⁃    Urinary Retention “I can’t pee right.”
    7.    Dyspareunia – pain during sexual intercourse
    8.    Intractable painPart 1 & Part 2
    9.    Vaginal scarring/shrinkage
    10.   Emotional Damage
    11.    Multiple surgeries
    12.    Neuro-muscular problems – nerve damage
              ⁃    Can’t sit down
              ⁃    Can’t walk
              ⁃    Wheelchair bound

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Most of these complications will require additional intervention, including medical or surgical treatment and hospitalizations.

About complete/full removals vs partial removals:

I think it is crucial to let you know the best best surgeons are saying that a complete removal of pelvic mesh is the only solution.  This is not the usual or accepted intervention done by most medical centers. We will concentrate on this very soon, but know this: in January of 2011, the National Institute of Health published this statement. “Complications seemed to be more frequent in the group with complete mesh excision, although this difference was not statistically significant.” I strongly recommend you print it out and take it to your surgeon when you are discussing solutions to mesh problems. Tell him/her that complications from complete removals are not statistically different from chipping away at the problem, setting up the patient for multiple surgeries and thereby spreading toxins and infections.

Please send questions or urgent problems by email to daywriter1@gmail.com Meshtroubles.com #pelvisinflames @daywrites