The Cleveland Clinic is renowned for some pretty innovative procedures and reputable doctors. Among them, Dr. Howard Goldman provides video demonstrates a “simple sling incision” which cuts a synthetic sling used to treat incontinence if the patient is having complications. Many doctors feel anything other than a complete extraction leaves behind the complications of synthetic mesh.
Remember mesh placement is intended to be a permanent medical treatment and the decision should not be taken lightly, especially in light of the FDA’s July 13, 2011 notification about benefit versus risks. (Background story here.)
*Editors note– His bio says Dr. Goldman has received funding from Johnson & Johnson, among others. Here is his bio.
According to Dr. Goldman, one to five percent of sling placements result in urinary or urethral obstruction. In the past, a full removal was recommended if there was an obstruction, but in this video on YouTube he shows how a simple sling incision can give a “positive outcome” and shows the incision of a midurethral polypropylene sling. In this video he actually cuts until he finds the blue sling- Warning– this is disturbing! Video here.
In the second YouTube video, Dr. Goldman shows the mesh incision of a bladder neck sling using a scapel. The surgeon must know the exact type of sling and where it’s placed, whether at the bladder neck or mid urethral area, as the cuts could be different. “This is a straight forward operation,” involving incision of the sling, he says.
Excision of Transvaginal Mesh Extrusion
In this video by Cleveland Clinic’s Howard B Goldman. Mia Swartz, a mesh “excision” allows for a complete removal. In this video a 71-year-old woman has mesh that eroded through the cystocele wall. Not only is it disturbing but so is the playful, light music.
“When managed properly, mesh extrusion should result in minimal patient morbidity” says the full screen graphic. Video is here.