Michelle Koski, MD

Michelle Koski, MD

May 28, 2013 ~ Medscape Medical News reports that all of those ads you see on television warning about the complications from transvaginal mesh are worrying women and raising a red flag about whether it is a viable option, but not scaring them away.  Story is here.

Women from two urology and urogynecolocy clinics were surveyed and  asked where they are receiving most of their information.

The answer- personal injury law firms. 

Dr. Michelle Koski says “It’s a vulnerable population and they are getting all of this misinformation.”

Dr. Koski, a urologist, presented the results of her survey at the American Urological Association 2013 Annual meeting in San Diego, California. Their website is here.

Ninety-nine women completed a questionnaire from clinics at Louisiana State University and the Medical University of South Carolina.  The results showed that although the information about mesh had come from law firms, three-quarters of women surveyed were still open to considering mesh as an option to treat stress urinary incontinence (SUI) or pelvic organ prolapse (POP).

In fairness, it is not just law firms warning of the complications of surgical mesh for women.  In July 2011, the FDA issued a safety communication stating that “serious complications associated with surgical mesh for transvaginal repair of pelvic organ prolapse are not rare.”

The FDA added that “transvaginally placed mesh in pelvic organ prolapse repair does not conclusively improve clinical outcomes over traditional nonmesh repair.

Nonmesh repair includes native tissue using just sutures to stitch up falling organs, or using muscle and tissue from the woman’s own body to create a sling.

It was that word from the FDA that was the spark that began the lawyer advertising you see today and the thousands of lawsuits that name primarily five mesh manufacturers in product liability lawsuits.

As far as mesh used in the treatment of stress urinary incontinence (SUI), the FDA said it, “continues to evaluate the effects of using surgical mesh to repair stress urinary incontinence and will communicate these findings at a later date.”   There has been no further word from the FDA on SUI mesh.

Informed Consent

Dr. Koski says she gives women a copy of the FDA warning and spends time talking about the lawsuit ads. She tells Medscape News, POP mesh has “positive aspects for certain patients.”

She speaks more favorably about slings used to treat incontinence.The transurethral sling has always been lauded for incontinence, but it’s getting dragged into this mess by people who don’t have any medical knowledge,” Dr. Koski said.

Dr. Koski reports she is not working on a study funded by American Medical Systems Inc., as Medscape reports.  AMS is one of the five primary mesh manufacturers that, at last count, was named in 6,781 lawsuits filed in federal court in West Virginia alone. Many more are filed in state courts around the country. #

 

The AUA Guideline for the Surgical Management of Female Stress Urinary Incontinence: 2009 Update

http://www.auanet.org/common/pdf/education/clinical-guidance/Incontinence.pdf

 

AUA 2013 Annual Meeting

http://www.aua2013.org/