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Questions to Ask Your Pelvic Mesh Removal Doctor

Explanted Avaulta mesh

Explanted Avaulta mesh

Mesh Medical Device News Desk, July 28, 2016 ~ What to ask the doctor before you have your pelvic mesh removed.

‘Kathleen” is not her real name. 

She is a woman who was implanted with transvaginal mesh years ago. Today she is suffering the consequences, including pelvic pain, chronic infections, as well as some autoimmune complications that mysteriously cropped up after she had the implant.

Kathleen has talked to countless doctors about her mesh removal and feels that her experience has helped her become well-versed in the questions that any woman should ask before considering the removal of her pelvic mesh.

First, are you having complications?  Unlike what Kathleen is currently going through, many women do not experience complications of pain, chronic infection and mesh erosion, at least not initially.   Experienced mesh removal doctors say complications may take years to emerge. According to Dr. Shlomo Raz of UCLA, a leading mesh removal doctor, he is seeing complications up to a decade after an implant.

Some percentage of women have complications initially, but that number is unknown because no one is tracking the big picture. Because the pelvic region is rich with blood vessels, nerves, ligaments and because a mesh implant is a permanent, blind procedure, it is fraught with potential problems.

A surgical nick to the bladder is not uncommon and will eventually heal, but an injury to the colon during the placement of a mesh in the posterior pelvis may not heal.   Sepsis is a very real possibility and a serious problem. Sepsis is a very severe and fast moving bacterial infection of the blood that originates from fecal matter. There are also the nerves, which may become impinged by a mesh placement or become encapsulated by scar tissue.

In the OR, Miklos and Moore

In the OR, Miklos and Moore

So what should you ask your physician to get the most complete removal in one surgery?

First, make sure he or she is one of the few experts at removing mesh.

Kathleen suggests you sharpen your interview skills and she suggests you bring along a friend. She did. The friend was a woman who had already undergone a removal and a reconstruction of her pelvic floor.

 

These are suggested questions. Find the words that work best for you but it truly is NOT a time to be shy.

  • Do you remove the mesh completely?
    Understand that partial removals are the norm by most doctors who snip away a small piece of mesh that has eroded into the vagina, for example. A full removal in one surgery is preferred for the reasons above.
  • How can you be sure you’ve removed the mesh in its entirety?
    Did the doctor measure the explant to see how many centimeters it contains?  By doing the math can he or she determine how much remains behind?
  • Do you remove the arms and anchors?
    This is an important question because many doctors will not enter into ligaments to further remove the plastic anchors that are dug deeply into the pelvis. In many cases, it may be too dangerous to do so. Ask your doctor what technique is used to remove anchors without causing more harm.
  • What diagnostic equipment do you have
    Some doctors like to “see” the pelvic mesh before they go to retrieve it. The transvaginal ultrasound is the only imaging device that will show the mesh, unless it is hidden behind a bone. Make sure a trained technician is operating the equipment to read it accurately.
  • Can you do repairs and reconstruction using my own fascia tissue graft within 6 months of removal if needed?
    Many doctors do not have the skill to retrieve or harvest fascia from your own body to create a sling that is biocompatible. Make sure your doctor can perform that surgery to treat incontinence or prolapse if it returns.
  • How many have you removed, completely?
    Make sure the person answers the question you asked and does not include partial removals in his tally.
  • Can you predict what reconstructive surgery I will need?
    After surgery you may need to follow up to repair any damage done during the removal. How often does this doctor do these surgeries and what will be needed to ensure the best results for you with the least amount of further injury. ##

 

 

4 Comments

  1. suki mann says:

    Just want to let everyone know that just asking a surgeon do they remove the mesh totally, does not mean thats what they do. I recorded the surgeon in the UK, when I asked this question and the surgeon states in detail that she removes 100% of the mesh and the anchors in the leg- I have it on tape. I then requested formally in legal form my mesh to be picked up and stored after the removal – showing that only 6 cm of the 22 cm inserted was removed. After 2 months of delays I get a report that clearly had past the hands of a solicitor that said that only 6 cm was removed and that this surgeon did not have the expertise to removed the arms and anchors ( even though after the surgery I was told ALL was removed) – . I had waited 9 months to see this surgeon on the promises of the recorded consultation – and therefore my advice to any woman is this –
    any consultation – record and keep records of because what is said and what is done or written in a report is not always the same.
    Always make sure you take photos of yourself below before and after any surgery because you are not always put back together the way you were before – I can tell you !! Where you have bruising and any sufficient areas like entry – scars and stitching needs to have photo evidence and a witness willing to say that picture is you.
    request copies of your medical notes that are kept by the surgeon – what they write about you in the hospital notes is not always the same – you will be surprised what they say! To wait until you need to ask for a lawyer means that your notes have the potential to be modified – but you will never have any proof to prove that is the case.

    My point is this – A surgeon will be horrified and outraged you want to record or have proof of what is said – but trust me big time – this is only so they can say what they like and that whatever they then write even if different to their verbal conversation with you is considered true and of good standing by the law – and the only person that gets screwed is YOU!
    Be smart and protect yourself …. only you and you alone has your interests solely at heart.

    ** ( the length varies depending on the type of device and your body – mine removed in total was 13 cm after more surgeries overseas and after shrinkage)

    • Jane Akre says:

      Excellent advice. Thank you… you are very smart. I would assume if your doctor is offended at the above, it might be time to part ways. Having all of your medical records is essential, ask for nurses notes, doctor notes, surgical notes, after every medical event… that way there is less chance that some notes may go missing. Women talk about it all the time – the notes do not reflect what transpired or are in direct contradiction to what WAS said… or they go missing entirely…. Thank you again.

  2. Sea says:

    Wish I had these questions before my mesh was removed…..A small piece of mesh was left along with the arm on the left pelvic area. Went to an test several days ago, now they want to put botox in my bladder or a pacemaker. That is not going to happen. Also, I have had two CT scans after surgery only a few months apart, then started having pain/problems in my left side. The 1st CT scan showed the mesh ….the 2nd CT scan showed no mesh…..I don’t know WHY the doctor did not remove everything …still in pain and was told I would probably be this way the rest of my life…..looking into another doctor now …Bummed out ….over mesh problems…..

  3. Linda says:

    I had great relief from the Botox while the mesh was I. I still have pain and saw Dr Hibner. He wants to try Botox again and I am waiting to see if insurance will cover. Botox saved my life as I could not live with the pain anymore.

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