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Dr. Walker Answers Your Questions About Pelvic Mesh Injury

Dr. Christopher Walker, Urogynecologist, Orlando, FL

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.”

Statue, WikiCommons

Statue, WikiCommons

 

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

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

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.”

 

S. asks:

“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.”

 

 

28 Comments

  1. Why does lawyers and doctors treat this mesh tragedy as “Woman issue,when men like myself go threw the same torturious pain…men also have pundendal nerves (nueralgia)and sciatic nerves as well…we also have testicles”.why arent men getting simular treatment and representation…”the mesh was found unfit for all humans”….why no relief for men????

    • Jane Akre says:

      The FDA in July 2011 said that mesh complications for pelvic organ prolapse are “not rare” an that opened the floodgates to litigation. The same thing has not happened for hernia mesh. One doctor has described the ignorance as similar to cigarettes in the 60s. So true. If only the FDA would recognize hernia mesh injuries. Has everyone you know who is injured reported it to the FDA?

  2. Dawn says:

    If the medical world doesn’t know the systemic effects of polypropylene mesh then why aren’t ALL DR.’S doing a patch test before PERMANENTLY IMPLANTING ???

  3. john nix says:

    In June of 2014 I had over 20 sq inches of hernia mesh and three nerves removed by one of the most prominent mesh removal surgeons out West. Two days after surgery I was sent home to Colorado. I was not prepared for the pain and trauma that followed once the general anesthesia wore off, I could barely stand or walk. It took my primary care physician ( PCP ) over 4 months to get the operative report and the report was not accurate. It had stated my surgery was done on the right, in fact, it was on the left. My PCP was very frustrated by the lack of post surgery help and recovery information. My Dr. and I were told in a consultation phone call with this surgeon that he’d performed hundreds of mesh removal surgeries, going back to the 1990s. It turned out there was little or no support or recovery data, just testimonials. The surgeon communicated with me briefly, then dropped communication with me when I needed it the most. There was No doubt I needed the mesh removed but, I let myself and my family down by not looking at other options with better professional follow up and care. I’m a rancher and there’s an old saying..’you can’t turn a pigs ear in to a silk purse’. Well, in this day and age with web sites and electronic advertising, that saying is no longer true.

    To this surgeons defense, months after I finaly got the operative report, a short questionnaire was sent out in an attempt to compile some follow up data. After filling it out, I was thanked and I have not heard from them since. Also, he broadcasts the need for surgeons to abandon mesh and learn the art of tension free techniques. As a husband, dad and grandfather, I am grateful for that!

    In summary: Please be extremely cautious with mesh removal, the recovery can be daunting! And, do your home work dilligently, even well intended people and sites can lead you astray. It is great to read about the likes of Dr. Walker who gives transparencey, follow up and long term care to the mesh damaged women he serves. I hope nothing but the very best for those who are going through mesh traauma. There is light at the end of tunnel!

  4. john nix says:

    I am glad for the courage of Jane Akre and Dr Walker, who follow the path of truth wherever it takes them. Sometimes truth is hard to swallow, just ask the fans of Lance Armstrong, Richard Nixon, Pete Rose and mesh manufacturers. The ‘truth shall set you free’ and we’ve all quibbled with it. Thanks Jane and Dr Walker.

  5. Yes,i reported my injury….its filed with them…Bard knows…the doctors know..the community knows…and the Supreme Court as well…..”With such technology,a solution for every victim shouldnt be a problem,this is very unhumane….”my vehicle had a recall,they handled a vehicle recall better than Human Endangerment,This mesh situation shouldnt sweep under the rug when they still putting those poisoness mesh inside people..”what type of justice system in America allows such human misconduct????Y does this seem very evil???????

  6. kitty says:

    Very excellent Q & A Dr Wslker. EXCELLENT ARTICLE. Also thank u Jane.

  7. kitty says:

    As I stated’—Dt Walker–your article was very very informative—yet confusing. What I have read on this site and maybe other sources is that—ALL the mesh has to be removed. Folks are saying their teeth are falling out–and illnessess that are inflammatory in nature are occurring. So if à person takes a patch test and all is clear—then “no problem” but wait!!

    TOXIC CHEMICALS WOULD NOT SHOW UP ON A SCRATCH. We gotta problem. Are we still using ChevronPhillips?

    • Mimiboops says:

      Hi Kitty,

      Can you elaborate a little more on what you said when you stated “Folks are saying their teeth are falling out–and illnessess that are inflammatory in nature are occurring.”? I have noticed my teeth have gotten BAD since I had pelvic mesh implanted back in July 2009. I just had partial removal this past November. In the last year, I have noticed that all of my teeth have receded terribly and I have developed decay at the gum line around most of my teeth! I never thought to put two and two together – that is could be related to the pelvic mesh. My goodness.

  8. Bejah B says:

    Thanks Kitty for bringing this up. I too believe that all the mesh needs to be removed as do many others and many experts so this is very puzzling. Especially because of the scar tissue complexities multiple removal surgeries and partial surgeries seem ill advised to say the least. Although I agree with much that was said, I am stuck on this question of full vs partial removal. I also think it is very helpful to victims to be able to have Q&A’s with physicians like this. We all appreciate, I am certain, the doctor taking time to answer some questions.

    I am reminded every time I use the word “victim” of the day in the spring I went to urgent care because my hands were swollen (Another probable effect of mesh wellspring of toxins) and the ring was actually cutting into my skin. The young doctor was very good and very nice. He actually used string to work the ring off. When I mentioned the mesh to him and used the word “Victims” he smiled reluctantly and said that I was cruel! I think he has no idea what is going on with this and that is so frustrating. At least mention of the word “mesh” took him to the right address in his mind.

    Bejah

  9. sickandtired says:

    Thank you Dr. Walker so much. After being told I was essentialy ‘crazy and all in my head’ by various doctors you have clarified so much for me. Not one doctor referred me elsewhere. I now know that a Urogynecologist is where I need to be. It’s quite maddening when no one wants to help you.

  10. Sally says:

    Two doctors recommended a partial hysterectomy for me in 2006. The dr that performed the surgery recommended the tvt sling along with the hysterectomy because she insisted that I would have bladder leakage after the hysterectomy. I did not have any problems with leakage but we do want to trust our surgeon so I finally consented to the extra procedure. After the surgery I went home with a catheter for eight days because I was unable to void after surgery. Even after the eighth day I returned to the doctor and still had trouble voiding enough for them to leave the catheter out. I stayed until I was able to make them content with that because I did not want to go home with a catheter again. Afterwards I had problems with repeated urgency, bladder infections, bleeding and I believe I may have had a kidney stone once which I have never had before or since. After repeated concerns and complaints to my doctor I finally took it upon myself to find a urogynecologist. After many tests she decided that I needed to have the mesh removed or cut completely to give me relief. I still have occasional pain in the area but I’m not sure where it’s really coming from and worried that it may give me more problems in the future. I do believe doctors were pushed by these manufacturers to perform these surgeries for the surgeons monetary benefit and the manufacturers getting rich. They should pay for what they have inflicted upon thousands upon thousands of others. I am glad to see the cases going forward in the settlements that these women are receiving.

    • Jane Akre says:

      Sally- You are right. Sitting in trial you hear how doctors thought they could double, triple their practice through this quick 20 minute “minimally invasive” procedure. J&J would charge a “premium prive” for this little strip of plastic. As a result of the sales pitch, doctors, many not even trained surgeons, attended weekend cadaver clinics to be taught by the manufacturers how to put mesh in a patient. For the practice, they used a hemi cadaver, ie, half of a cadaver. The cadavers never complained. For those who had trouble getting it, a sales rep would sit in the operating room and guide them on the procedure on a live patient! Sales reps are not surgeons, you know, or even MDs. At some point, any point, someone might have stopped this gravy train and asked the big picture question – Has this stuff even been tested on humans? The answer is no.

      • Sally says:

        I’m learning so much more from reading the information on your site. Thanks for the help, information, and encouragement you are giving so many women.

        • Jane Akre says:

          Please use the Search bar to find more. Click on each topic and a parade of stories will appear under neath. There are nearly 700 stories now. I’m going for 1,000… anyone want to help!?

  11. Bejah B says:

    Nice tight little summary Jane, with just the right amount of heat. You are so good!

    BTW love your puppies. I used to have four and it was not a hardship at all, quite the opposite. Now I have just two. Animals enrich our lives so much. Those of us who do not live with animals…it helps to heal you…I think it would benefit mesh wounded women (people) to have an animal in their lives. Mine are a great comfort to me. They seem to know so many things.

    Bejah

    • Jane Akre says:

      I love them too… though Peanut the poodle is getting on in age… he’s wearing diapers these days.. Oh well! Still love him.

  12. Tammy Barnett says:

    When Dr.Marc Ashby did my exam he checked my rectum which I was a little confused about at first in 2010 I had a Vaginal Hysterectomy with mesh on my Urethra I actually was made incontinent from that moment on! After the exam Dr.Marc Ashby told me that he felt what he believed to be mesh not only on my Urethra but behind my vaginal wall on my bowel’s! I was shocked and mad as heck because I was not informed of it! What I want to know does that happen a lot?? The mesh on my bowel’s???

    • Bejah B says:

      Tammy B, What a horror, I am so sorry. At least now you know and can develop an action plan. Knowing is better than not knowing almost always. It sounds like you have a good physician in this doctor. Just do what you need to do, do what you can and move on as best you can. I am sure we will all pray for you. I learned not too many years ago how powerful prayer can be,

      Bejah

  13. MAMOHIO says:

    I had SUI, in 2005 I had J & J TVT, it eroded into my Vaginal wall by 2008. They only removed the part that eroded called a revision surgery. Then they wrapped an AMS sling around it. I have nothing but pain in my back and lower pelvic area plus stabbing pain in the vaginal area. I have fibromyalgia they say but I have pain in my hands, feet, stomach and back daily. If you had SUI surgery does it affect the Pudenal nerve or is that just POP patients. I would also like to have blood work to know if toxins are in my system. Where would I go for that info? Plus I would like to see thru an MRI or CAT scan if the TVT tape is continuing to erode since it was only partially removed. What kind of test can be done to see that? Thanks for all your help. God bless

    • Bejah B says:

      What is the translabial ultrasound? Would that help you? I wonder why so many physicians do not seem to order these tests, are they unaware, does the medical center they are affiliated with not have this equipment, or is it a cost vs. insurance coverage issue? Are they told by their dept heads what to order or not order with an eye to the profit margin of the medical center. So many questions. Maybe what we should do is look to the manufacturers of medical imaging equipment and approach it that way, find out where the latest, most comprehensive testing equipment is and find a way to go there. In my situation, for example, I have a menu of health plans I can select from. For 2016 I am going to drop high option so I can save money and pay some bills then go back to it or some other for the following year. One could sign on for high option for one year just so you can pay for those tests (high option pays everything at 100% but it is painfully expensive. Just some ideas that may help you. With ya in spirit.

      Bejah

    • Karen Haney says:

      I would like to know this as well. I had the J&J tvt implanted in 2005. And a few months later it tore loose and eroded into the vaginal wall. I lived with this for 9 years, I had it removed in 2013, now I have stage 4 Fibromyalgia and possibly dysautonomia. This has left me totally disabled. I have not been able to work since 2013. Have been left homeless twice due to the loss of income. My social security disability has been denied 3 times. I am still having sharp stabbing pains in my bladder area and vagina. Im scared to have more surgeries because the dysautonomia affects my breathing, and I’m afraid to now be put to sleep for fear of respiratory arrest.

  14. Renee says:

    With all the issues surrounding nerve pain, could there be a connection to Fibromyalgia? I never had any type of nerve pain until 5 or 6 months after my mesh was inserted.I was diagnosed with Fibromyalgia some months after that. I had the mesh removed but still suffer from the nerve pain. I am o n 3 medications for it and still have pain. Or is it possible I could have been diagnosed? I was overweight before all this but never lived in pain or had nerve issues before the mesh.

    • Jane Akre says:

      Many women develop autoimmune issues after their mesh implant, fibromyalgia among them. Could it be a coincidence?

      • Karen Haney says:

        I have stage 4 fibro, and my dr is pretty sure dysautonomia as well….it has destroyed my life. Please read my post above!

  15. Hello. I’m seeking information on ethicon hernia mesh. Can you give me any information on where I can find any? (Information that is…)

    • Jane Akre says:

      Bruce Rosenberg will be able to answer your questions. He is hernia mesh injured and very knowledgeable. 954-701-5094.

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