Dr. Christopher Walker, Urogynecologist, Orlando, FL
Mesh News Desk, August 19, 2015~ MND editor, Jane Akre asked many of you on our Facebook page to pose questions to Dr. Christopher Walker, a urogynecologist located in Orlando, Florida. He is one of the new doctors around the country who is capable of addressing mesh explants (removals) and mesh injury with a minimum of harm to the women. Dr. Walker is also a sponsor of MND.
Dr. Walker also has a kind and caring nature and relates the ethics of mesh use to what he would do for the people he loves. Please read his profile on Mesh News Desk here.
The following are your questions and his answers. The women will remain anonymous as many are still represented by legal counsel.
S. asks:" First of all do you often recommend a full mesh removal? If a woman wants a full mesh removal, what issues do you weigh and how often are you able to do a full removal?
Dr. Walker: "Each patient will require an individualized treatment plan.. many variables have to be taken into consideration when deciding if a partial vs. full mesh implant removal is required such as the patients presenting complaint, presence of a fulminant mesh infection etc...; With the above said, most patients do not require a full mesh implant removal."
T. asks: "I'd love to know if after partials, then finally full removal of my mesh if there is ever hope for pain relief in the pudendal, and obturator nerves. I have severe scarring, and have seen little if any improvement."
Dr. Walker: "Due to the process of scarring and nerve entrapment, some patients have permanent lifelong nerve injuries and the sequelae thereof, which includes pain and dysesthesia."
S. asks: "What causes stabbing, like a knife in the vagina five years later?"
Dr. Walker: "This symptoms is most likely due to nerve injury which is manifesting as sensory neuropathy."
J. asks: "As far as surgical questions does mesh removal from a TVT-O do more harm than good? Why does a partial removal cause more pain?
Dr. Walker: "A partial mesh implant removal should not cause more pain. In fact most patients (>80%) have a resolution of their pelvic pain with this procedure."
TVT-O from IFU
E. asks: "Yes, I had 3 partial removals and each was worse plus 4 fistulas and infections. The pain never stopped and I still have pain. Wonder what made the bladder stop working?
Dr. Walker: "The process of scarring and tissue fibrosis which will occur after each surgical repair in addition to the severe tissue inflammation in response to a fistula can result in nerve entrapment and permanent pelvic pain. The location of the fistulas to the bladder neck can affect the continence mechanism and thus result in a permanent voiding dysfunction."
S. asks: "How do we get a Dr to listen to us?? What can we say that would make a difference in the way we are treated?? Getting really tired of hearing; "ITS ALL IN YOUR HEAD, YOUR JUST DEPRESSED"!! I'm thinking anyone would be depressed if they put on our shoes!!!!
Dr. Walker: "Firstly, pelvic pain and the many complications that can result from a mesh implant are not imaginary!!!. I suggest seeking the assistance of a Board Certified Urogynecologist."
L. asks: "Does Dr Walker believe that the ingredients that Mesh is made of have a long term effect in a person's body? And the more years you have it in, the more distributed it goes in body and filters into organs?"
Dr. Walker: "The Polypropylene mesh usually has an impact locally versus general side effects. It is, however, known that some patients demonstrate an allergic reaction to Polypropylene and thus may have IgE-mediated-like reactions such as contact urticaria and a possible systemic reaction."
Prolene mesh and particles
D. asks: "What can we do to rid our bodies of the toxic substance that mesh leaves behind in our cells?"
Dr. Walker: "Unfortunately the scientific literature is sparse in this arena and thus we truthfully do not know what possible systemic effects may arise in the future from polypropylene mesh implants."
"Is it possible to be allergic to the mesh implant?
Dr. Walker: "There have been cases reported to suggest an IgE-mediated-like reaction such as contact urticaria and a possible systemic reaction. To confirm if one has an allergy to the Polypropylene mesh a Patch test could be performed by an Allergist."