Pelvic surgeon: transvaginal mesh violates core surgical principles

mesh1 Pelvic surgeon: transvaginal mesh violates core surgical principlesEvery year, about 300,000 women in the United States undergo surgery to correct pelvic organ prolapse (POP), a condition in which age, childbirth, and other factors weaken the muscles that keep the pelvic organs (uterus, bladder, and bowel) in place, causing them to sag and protrude into the vagina. To correct POP and incontinence problems, a growing number of surgeons are using transvaginal mesh, devices designed to shore up the pelvic muscles and provide an alternative to conventional surgical methods that repair the muscle. In 2010, nearly 80,000 women were implanted with transvaginal mesh.

But not all surgeons think that transvaginal mesh is the best way to correct POP or stress urinary incontinence (SUI). In fact, some surgeons familiar with the mesh, such as Dr. Tom Margolis of Bay Area PelvicSurgery, are outspoken critics of the devices, which many women blame for causing permanent, sometimes crippling pain and injury.

Dr. Margolis, whose clinic specializes in removing transvaginal mesh, believes the mesh products are fundamentally flawed because they “contradict core principles of surgery,” as investigative journalist Lindsay Beyerstein notes in a recent report, “A Female Surgical Nightmare.”

Ms. Beyerstein writes that Dr. Margolis paid his own expenses to testify about the dangers of transvaginal mesh at a meeting of the U.S. Food and Drug Administration (FDA) last September. Dr. Margolis explained to the panel that the vagina can’t be completely disinfected before surgery; therefore, passing the porous mesh through the vagina to implant it inside the body violates the Golden Rule of Surgery: “You shall never implant a synthetic object in anyone’s body, anywhere, if it’s contaminated.” To do so is to put the patient at serious risk of infection.

Painful, potentially life-threatening infections are just one complication reported by some women implanted with the devices. The devices are known to puncture organs, cause bleeding, and erode through the vaginal walls, creating intense pain that can ruin a woman’s sexuality and even put her male partner at risk of laceration. And, because they’re designed to meld with the surrounding tissue, transvaginal mesh can be extremely difficult – sometimes even impossible – to remove.

“The proponents of mesh have shown that there’s erosion at a rate of 15.6 percent, and that’s magnificently high — and I’m not using magnificently in a good context,” Dr. Margolis told America Now News. “That’s an insanely, suicidally high complication rate.”


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