Women who developed problems following recent vaginal mesh procedures are gradually increasing in number, medical industry journals say. Consequently, lawsuits related to faulty vaginal mesh devices like the Ethicon trials set this November are multiplying as well.
Patients with pelvic organ prolapse opt for vaginal mesh implantation not only because it immediately puts an end to the embarrassing symptoms they acquire from pelvic organ prolapse, but most importantly because doctors recommend the use of these devices. During prolapse repairs, some doctors surgically implant a synthetic sling for urethral support to avoid future bouts with incontinence. Other specialists, however, raised objections to this practice. According to Dr. Kovac during the international conference on pelvic reconstruction and vaginal surgery, this prophylactic sling procedure during prolapse repairs still needs to be studied and carefully analyzed before doctors perform them to their patients.
Other surgeons reported that most of their patients who received vaginal mesh treatment had developed incontinence as a result of the procedure. They claimed that if a sling is not placed as incontinence precaution, patients will eventually develop urine leakage and may be required to undergo another procedure to correct the disorder. To avoid compromising the previously repaired prolapse, doctors perform sling supports during the prolapse procedure.
Although this prophylactic approach works for most of the patients, it also has its disadvantages. Based on a study, complications like bladder punctures, internal bleeding episodes, urinary tract infections, and insufficient bladder emptying (urinary retention) are seen as consequences of sling procedures.
Urinary retention is a simple complication; but it may lead to damaging physical disorders like renal failure. This must be the reason for some experts believe that placement of slings even without incontinence symptoms needs to be entirely avoided. Performing the attachment of slings as prophylaxis for incontinence remains an unsolved clinical problem. While some perform this routinely on their prolapse patients, others postpone it until symptoms of incontinence actually show up and affect the patient’s quality of life.
Still, there were also some medical service providers who discuss the possibility of incontinence to their patients first and let them decide whether to agree on sling prophylaxis or not. In this manner, doctors ensure that the patient is adequately informed of the complications that may come thereafter. With the increasing numbers of complaints related to mesh use and the rising trend of vaginal mesh lawsuit cases, patients need to be careful when considering the implantation of these meshes in treating the symptoms of prolapse and incontinence.
References:
http://www.medscape.com/viewarticle/749960
http://www.internalmedicinenews.com/index.php?id=514&tx_ttnews%5Btt_news%5D=78692&cHash=88c0be9bb1
http://www.renalandurologynews.com/prophylactic-slings-may-prevent-incontinence-after-pop-repair/article/210742/
http://www.sciencedirect.com/science/article/pii/S0022534705679189
Patients with pelvic organ prolapse opt for vaginal mesh implantation not only because it immediately puts an end to the embarrassing symptoms they acquire from pelvic organ prolapse, but most importantly because doctors recommend the use of these devices. During prolapse repairs, some doctors surgically implant a synthetic sling for urethral support to avoid future bouts with incontinence. Other specialists, however, raised objections to this practice. According to Dr. Kovac during the international conference on pelvic reconstruction and vaginal surgery, this prophylactic sling procedure during prolapse repairs still needs to be studied and carefully analyzed before doctors perform them to their patients.
Other surgeons reported that most of their patients who received vaginal mesh treatment had developed incontinence as a result of the procedure. They claimed that if a sling is not placed as incontinence precaution, patients will eventually develop urine leakage and may be required to undergo another procedure to correct the disorder. To avoid compromising the previously repaired prolapse, doctors perform sling supports during the prolapse procedure.
Although this prophylactic approach works for most of the patients, it also has its disadvantages. Based on a study, complications like bladder punctures, internal bleeding episodes, urinary tract infections, and insufficient bladder emptying (urinary retention) are seen as consequences of sling procedures.
Urinary retention is a simple complication; but it may lead to damaging physical disorders like renal failure. This must be the reason for some experts believe that placement of slings even without incontinence symptoms needs to be entirely avoided. Performing the attachment of slings as prophylaxis for incontinence remains an unsolved clinical problem. While some perform this routinely on their prolapse patients, others postpone it until symptoms of incontinence actually show up and affect the patient’s quality of life.
Still, there were also some medical service providers who discuss the possibility of incontinence to their patients first and let them decide whether to agree on sling prophylaxis or not. In this manner, doctors ensure that the patient is adequately informed of the complications that may come thereafter. With the increasing numbers of complaints related to mesh use and the rising trend of vaginal mesh lawsuit cases, patients need to be careful when considering the implantation of these meshes in treating the symptoms of prolapse and incontinence.
References:
http://www.medscape.com/viewarticle/749960
http://www.internalmedicinenews.com/index.php?id=514&tx_ttnews%5Btt_news%5D=78692&cHash=88c0be9bb1
http://www.renalandurologynews.com/prophylactic-slings-may-prevent-incontinence-after-pop-repair/article/210742/
http://www.sciencedirect.com/science/article/pii/S0022534705679189