“I have removed more than 900 mesh for complications in the last 5-6 years. Translabial ultrasound is an important adjuvant to the diagnosis and treatment of this patients.”
Those are the words of the leading mesh removal surgeon in the world, Dr. Shlomo Raz, MD in an exchange with Mesh News Desk.
The Professor of Urology at the David Geffen School of Medicine at the University of California Los Angeles (UCLA) attends to the most difficult mesh removal complications and sees patients from around the globe who are having complications with their transvaginal mesh implants.
The difficulty of mesh removal is complicated by the fact that mesh used to treat prolapse and incontinence is implanted in a woman’s pelvic region and is intended to be a permanent implant. Removal is difficult. In some cases, a removal surgeon will take just a portion of the implant and leave the rest.
The long-term result can be further mesh degradation and an acceleration of the release of mesh debris in the body.
Mesh News Desk wanted to know about the availability of the only imaging device that appears to “see” polypropylene mesh- the translabial ultrasound. An MRI will not see plastic mesh, neither will a CAT scan.
“The machine is readily available in any radiology center. There is no specific brand or equipment required. The same ultrasound that performs pelvic ultrasound with the ability to perform 3d reconstruction will do it.”~ Dr. S. Raz
Dr. Raz attached a copy of a case of 3 dimensional reconstruction of a mesh that had penetrated the urethra and the bladder.
“We have design a protocol that we follow with great success. We do different views of the pelvis, bladder, rectum and urethra including sagital, coronal and axial cuts.
“We do tri-dimensional reconstruction of the mesh location. Many patients had partial mesh removal. The ultrasound will show how much mesh is left over.
The mesh can penetrate the bladder or the rectum or the urethra and the ultrasound will detect it. Many patients were told that the mesh was removed but actually was not.”
The ultrasound machine used in Gynecology-Perinatology can be used, according to Dr. Raz.
UCLA Department of Urology, Los Angeles