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Transvaginal and Hernia Mesh Still Used Today - What You Should Ask?
Jane Akre
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June 5, 2018
Mesh Medical Device News Desk, June 5, 2018 ~ Your editor of Mesh News Desk is hearing from newly mesh-implanted women who are being told the same thing. (Talking points carefully crafted by public relations professionals?) That is - this is a "New Mesh" not the same mesh you've heard about in the lawsuits. That ultimately is the only way to "sell" a product or to continue selling mesh use on the public as a first line defense against incontinence or pelvic organ prolapse. But is it true?
Image: Creative Commons, Serena Wong
NEW MESH OR NEW NARRATIVE?
By now, most people have heard that there are a high number of product liability lawsuits filed against mesh manufacturers. Johnson & Johnson and its Ethicon division, Boston Scientific, C.R. Bard, American Medical Systems, Coloplast, Cook Medical and Neomedic are the focus of more than 104,000 cases filed in one federal court in West Virginia. And the verdicts have been generally favorable to the plaintiff, ranging from $1 million to $100 million.
A recent 60 Minutes storyon Boston Scientific and its shady methods to secure new raw polypropylene put a dark stain on the company and caused industry-wide reaction. Generally that comes in the form of hiring public relations professionals to "craft" a new narrative and issue "Talking Points" to quiet the public concerns.
Though MND has not yet seen those talking points (please sent them) this is the MO of corporate crisis counseling. Regardless, women are reporting they are being told that the mesh today is "New Mesh" and not that same stuff the lawsuits are about.
There have been too many report to disregard this as random narrative and not corporate re-branding. So if you have stress urinary incontinence(SUI), urge incontinence, pelvic organ prolapse (POP) or a hernia, and your doctor is suggesting mesh:
WHAT DO YOU ASK?
While its true the major mesh manufacturers are playing around with the weight of the mesh and the pore size, basically most mesh is still made of polypropylene (PP) a cheap plastic woven from raw PP resin. So some suggested questions you might want to ask your doctor. Make sure he/she answers the questions:
What is the mesh you use made of? (Answer: polypropylene, biologic or composite or coated is what's on the market. Even biologic ( pig, cow or cadaver) or coated generally merge with a PP base. If your doc says its "Marlex" or Prolene" or Gynemesh, it's all polypropylene! Make sure they don't pull that one on you. )
How is it new? (Answer: He/She may say its entirely different, get an answer - How is it new? Your doctor may be following the guidance of medical societies that favor using mesh as a first-line defense.)
Is it polypropylene? (Answer: Pay attention to this answer. Your medical provider may not even know, though he/she should know. PP is a polymer plastic sourced from the petroleum industry. It is also used for Tic Tac box tops and indoor outdoor carpet).
What is the brand name of the product you use? Who makes it? How long have you been using it? (Answer: See how honest and up front the provider is).
Are there any alternatives to using mesh? (Answer: Unless you have had a mesh repair previously and it has failed, unless you are obese and a smoker, there are generally alternatives to starting off with a mesh repair. We've learned from litigation that it may not be the best choice for a first line defense against SUI and POP).
Am I a candidate for a non-mesh repair and can you do one? (Answer: This is important. Many newer doctors have not been trained in doing anything but using mesh to treat SUI and POP. Ask if they can do a suture only repair).
Can you do a native tissue repair? (Answer: This involves harvesting fascia from your body and using it as a "sling" so your body does not reject it. This also involves more surgical skill and takes longer and ultimately may not be as profitable for your provider as a 20 minute sling procedure. If your doctor cannot do this type of repair, why not? Isn't going conservatively the best way to start? Does he understand the most experienced docs are not using mesh for slings?)
How many native tissue repairs have you done? (Answer: Will you become an experiment? You want to chose a provider who understands this method).
If needed, can you remove my mesh if it causes complications? (Answer: Pay careful attention here, even the best doctors have trouble removing the arms or anchors that are punctured deep into ligaments, leaving behind lasting pain potentially. If a doctor says he can, ask "How do you know?")
What is your relationship with the mesh manufacturer? (Answer: Look up Dollars for Doctors prior to your appointment. A database from ProPublica, it has documented the financial relationship between doctors and the manufacturers and might be one factor you want to consider. Can a doctor who has received $1 million from Ethicon be providing unbiased information about Ethicon mesh? You decide.)
Image: Creative Commons
If your doctor hasn't thrown you out of the office by now, you may have found a good one who is willing to have a true informed consent. Good for you for becoming an informed consumer!
