6 Reasons Mesh is Not “Inert”
Mesh is a moving, writhing, migrating, twisting, grasping, destructive device that continues to harm as long as it is inside the human body and leaves permanent damage behind when it is taken out. Thousand of people with mesh trouble are not finding any help or even sympathy inside the doctor’s office. One patient after another says that her doctor said her pain, nerve damage, difficulty urinating, prolapse, fatigue, etc., could not possibly be from her pelvic sling or hernia mesh because the mesh is “inert.” That is plain out not true.
In his letter to the New Zealand Parliament, Dr. Vladimir V. Iakovlev, MD, FRCPC, FCAP, anatomical pathologist and director of the Cytopathology Department at St. Michael’s Hospital in Toronto, Canada, debunks this fallacy through very credible research findings.
After placing about 230 explanted mesh, approximately 150 of them transvaginal mesh, under a microscope, he found degradation, nerve damage, curling of the edges of the mesh causing deformities (especially with TOT mesh), migration of the mesh into healthy organs causing vaginal, bladder, and bowel problems, shrinking of scar tissue causing deformity and over-tightening, and increasing changes in aging bodies.
In a departure from previous pathologists’ examinations, Dr. Vladimir V. Iakovlev, MD, FRCPC, FCAP looked at the connection between the complaints from the patient and how the mesh appeared under his microscope. Where patients complained of pain, he discovered tiny bundles of nerves had grown into the mesh and became entrapped, forming tiny traumatic neuromata, thus validating the experiences of hundreds of women who were told the pain was not coming from the mesh.
Here are Iakovlev’s six complications leading me to call into question the unfettered use of mesh inside a human body for any reason:
1. Degradation of polypropylene.
The outside of the implanted plastic mesh becomes brittle and leachable to surrounding tissue and can enter the bloodstream where it can release toxins. The part of the mesh that touches the woman’s bodily tissue—become brittle and more porous to the dyes put on it during the pathological examination. Iakovlev recommends the mesh be easily removable, especially in younger patients. Transvaginal mesh is known to be implanted in fertile women.
2. Compartmentalizing nature of the mesh.
Mesh is made by knitting or weaving together stands of polypropylene plastic which leave small openings in which new tissue grows. Each pore can act as a “tunnel’ or constriction point for the nerves and blood vessels which grow between the strands. As the mesh folds, it forms new “compartments” filled with living tissue which can become compartmentalized, a serious injury.
3. Device migration.
Contrary to a recent explanation by a mesh explant surgeon, mesh migrates. After implantation and a return to normal, every-day movements like walking, running, evacuating the bowel and bladder, or sexual intercourse, transvaginal mesh moves into and through the walls of the urethra, bladder and rectum. The damage has been found in the muscular layer of the organs, neural ganglia, nerves and arteries.
4. Device deformation (mesh curling/folding).
Bladder sling mesh edges curl into complex folds and every single explanted pelvic organ prolapse devices bunched up causing mesh exposure in mucosal tissue. The deformed mesh parts become encased in scar tissue forming “bulky, firm, and irregular structures.”
5. Scar contraction.
Scar tissue contracts bringing the mesh fiber with it as it matures and shrinks. The device can be pulled too tight or become deformed. Newer hernia mesh has been invented to minimize the forming of scars but the pores in those mesh are too large to be used for midurethral (pelvic) mesh slings.
6. Long term effects and risks.
With mesh being implanted in young folks, life-long risks are important and neglected topics. Can it be safely removed? While most physicians shy away from removing the parts planted deeply into the obturator spaces, removal should continue to be a major concern for decisions to receive an implant or for future research by professionals.
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