Chronic Pelvic Pain Protocol

//Chronic Pelvic Pain Protocol

Chronic Pelvic Pain Protocol

Mesh Medical Device News Desk, December 18, 2018 ~ This YouTube video is produced by Dr. Greg Vigna and Dr. Michael Hibner concerning the treatment of pudendal neuralgia, or nerve pain following a synthetic vaginal mesh or sling implant. 

Pudendal neuralgia (PN) is associated with the use of a trans-obturator placement of pelvic mesh, that is a treatment for stress urinary incontinence (SUI) that involves the use of a polypropylene surgical mesh (or ribbon or sling or hammock, all describe a SUI mesh) to support the urethra.

Running the mesh through the obturator space presents additional challenges to movement and additional potential for pain and damage. 

The TVT-O (tension free vaginal tape obturator, has been found to be defectively designed in several product liability trials, yet it remains on the market. 

Image: Dr. Michael Hibner

TVT-O from


Chronic Pelvic Pain Treatment Protocol

Pudendal neuralgia pain may result in a burning sensation or dyspareunia, pelvic pain with sitting, discomfort with tight clothing, problems with the bladder and/or bowel, genital or anal pain.

According to Dr. Hibner, a urogynecologist based in Arizona, when a patient comes in she is first subject to an MRI imaging.  On the same day, she receives a physical therapy assessment, all part of diagnosis and initial treatment. 

Then if the are pelvic floor muscle spasms, she is scheduled for Botox injections then vaginal suppositories. She will receive Botox injections and wait 2 weeks for it to be effective. If the patient has pain relief after Botox, it’s a pelvic floor muscle spasm as opposed to pudendal neuralgia.

If there is no relief of pain after Botox, the patient is offered three CT Guided Nerve Blocks. The goal is to diagnose pudendal neuralgia and deliver steroid to relieve pain. If a patient receives four, five or six months of pain relief, he will not offer that patient surgery but tell them to return every six months.  

Next they proceed with surgical removal of all of the mesh including the arms vaginally and abdominally. He uses a robot in the abdomen to find the arms. If part of the mesh is removed and the arms only remain,removal is much more difficult. Surgery could take six to ten hours which includes a Burch procedure, an anti-incontinence surgery.    

See the YouTube video here. ###

By |2019-01-16T13:32:05+00:00December 19th, 2018|Medical News|8 Comments

About the Author:

I’m National News Editor, Jane Akre and I began Mesh Medical Device News Desk aka Mesh News Desk (MND) in the summer of 2011 just after the Food and Drug Administration issued an explicit warning to the public that complications associated with surgical mesh used for prolapse repair (POP) and incontinence (SUI) are NOT rare! That was the starting point for the litigation you see today and thousands of lawsuits have been filed by women whose lives have been altered, some permanently, by the use of this petroleum-based product.


  1. Anonymous December 21, 2018 at 6:45 am - Reply

    Omg that’s amazing what this gentleman can do I wish u could see this man he really is amazing I only wish I could see him 👍

  2. Emmie December 21, 2018 at 11:50 pm - Reply

    Dr. Hibner removed 90% of my 3 mesh implants in July 2016. He is an amazing doctor and I would highly recommend him.

    Unfortunately the mesh damaged my pudendal nerve and other nerves too. So I still remain in pain and get painblocks about 4 times a year. They give minimal relief for a few werks.

    Some mesh remains in my groin area because it was to much of a high risk to remove.

    The long painful flight and 7 hour surgery gave me instant relief in my hips. After 9 days in Phoenix for surgery and review, it was amazing how the flight home was actually much easier
    even after the 7 hour intense surgery.

    The mesh was wrapped around my hips and growng into my pelvic bone.
    Unfortunately my pudendal nerve was damaged and I still have constant pain and have at least 4 painblocks a year that give me minimal relief. Constant UTIs too.

    If only I knew what JnJ knew, they ruined many lives of innocent women and only for the greed of money. I well never get back to my non-mesh day health and continue to suffer the rest of my life.

    Thank you Dr. Hibner for getting most of my mesh out of my body!!

  3. Wren December 21, 2018 at 11:56 pm - Reply

    He is AMAZING ! I’m am his patient and feel incredibly blessed. I have been with him for 11 years. I had my sling put in in 2007 ( from a different surgeon) with a bad outcome and he removed it in 2012. Unfortunately my pain continues but he has been my hero to find anything to help with pain management. I can’t give him enough praise for his commitment to medicine and to his patiences. Thanks Dr Hibner. Your the best!

  4. George December 22, 2018 at 6:41 pm - Reply

    Have had mesh ex-plant surgery several times. Now when I get an MRI from two institutions that know I been in class action litigation from failed mesh, the mesh that remains is not documented. Although in the past it always was, position, change since last mri, etc. My medico friends say it called being branded and the only surgery I will ever have now, if I go through the ER in dire need. Be careful out there, the pain and suffering continues after settlement for me, the amount is not a quality life improvement. These companies write it all off and have insurance. Capitalism does not account for excellence in medicine.
    Hey but have a Merry!

    • Jane Akre December 23, 2018 at 9:46 am - Reply

      You may require ultrasound to image your mesh, not an MRI, but your doctor should know that.

  5. Christine December 23, 2018 at 6:53 am - Reply

    Where is he located in Arizona?

  6. Anonymous December 24, 2018 at 9:39 am - Reply


  7. Anonymous December 24, 2018 at 11:55 am - Reply

    Dr. Michael Hibner is located in Phoenix Arizona, 602.406.6017.

    Dr. Hibner and his entire staff are absolutely wonderful. I discerned almost instantly, that he and his staff labor in the health care field because they genuinely care about the patient’s health and not if the patient can afford the services. I flew hours for the honor of meeting Dr. Hibner, also to get another assessment of my present mesh condition. Dr. Hibner and his entire staff delivered the most pleasant professional interaction in the field.
    P.S. I was not asked to make a co-payment nor did I receive a bill after the visit.

Leave A Comment