Dr. Michael Hulse Obgyn Canton Ga POP treatment warnings

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Recommendations for Health Care Providers Treating Pelvic Organ Prolapse
The FDA recommends the following to health care providers using surgical mesh to treat pelvic organ prolapse (POP):

Training
Obtain specialized training for each mesh placement technique, and be aware of the risks of surgical mesh.

Patient Selection
Recognize that in most cases, POP can be treated successfully without mesh thus avoiding the risk of mesh-related complications.Choose mesh surgery only after weighing the risks and benefits of surgery with mesh versus all surgical and non-surgical alternatives.
Consider these factors before placing surgical mesh:Recognize that in most cases, POP can be treated successfully without mesh.
Surgical mesh is a permanent implant that may make future surgical repair more challenging.
Having a mesh surgery may put the patient at risk for requiring additional surgery or for the development of new complications.Removal of mesh due to mesh complications may involve multiple surgeries and significantly impair the patient’s quality of life. Complete removal of mesh may not be possible and may not result in complete resolution of complications, including pain.
Mesh placed abdominally for POP repair may result in lower rates of mesh complications compared to transvaginal POP surgery with mesh.

Informing your Patient
Inform patients that implantation of surgical mesh is permanent, and that some complications associated with the implanted mesh may require additional surgery that may or may not correct the complication.
Inform patients about the potential for serious complications and their effect on quality of life, including pain during sexual intercourse FOR HER PARTNER, scarring, and narrowing of the vaginal wall in POP repair.
Inform the patient about the benefits and risks of non-surgical options, non-mesh surgery, surgical mesh placed abdominally and the likely success of these alternatives compared to transvaginal surgery with mesh.
Notify the patient if mesh will be used in her POP surgery and provide the patient with information about the specific product used.
Ensure that the patient understands the postoperative risks and complications of mesh surgery as well as limited long-term outcomes data.
Provide patients with a copy of the patient labeling from the surgical mesh manufacturer if available.

Follow-up with your patient
Be vigilant for potential adverse events from the mesh, especially erosion and infection.
Watch for complications associated with the tools used in transvaginal placement, especially bowel, bladder and blood vessel perforations.



Recommendations for Women with Pelvic Organ Prolapse
It is important that women are aware of the risks associated with surgical mesh for transvaginal repair of pelvic organ prolapse (POP). Women who have mesh surgery may be at risk for needing additional surgery due to mesh-related complications. In a small number of patients, repeat surgery may not resolve complications.
Ask your surgeon about all POP treatment options, including surgical repair with or without mesh and non-surgical options, and understand why your surgeon may be recommending treatment of POP with mesh.
If you are considering surgery with the use of surgical mesh to repair your POP, ask your surgeon these questions before you agree to the procedure:
Are you planning to use mesh in my surgery?
Why do you think I am a good candidate for surgical mesh?
Why is surgical mesh being chosen for my repair?
What are the alternatives to transvaginal surgical mesh repair for POP, including non-surgical options?
What are the pros and cons of using surgical mesh in my particular case? How likely is it that my repair could be successfully performed without using surgical mesh?
Will my partner be able to feel the surgical mesh during sexual intercourse? What if the surgical mesh erodes through my vaginal wall?
If surgical mesh is to be used, how often have you implanted this particular product? What results have your other patients had with this product?
What can I expect to feel after surgery and for how long?
Which specific side effects should I report to you after the surgery?
If I develop a complication, will you treat it or will I be referred to a specialist experienced with surgical mesh complications?
What if the mesh surgery doesn’t correct my problem?
If I develop a complication, will you treat it or will I be referred to a specialist experienced with surgical mesh complications?
If I have a complication related to the surgical mesh, how likely is it that the surgical mesh could be removed and what could be the consequences?
If a surgical mesh is to be used, is there patient information that comes with the product, and can I have a copy?

If you have surgery with mesh to repair your POP, you should:
Continue with your annual and other routine check-ups and follow-up care. There is no need to take additional action if you are satisfied with your surgery and are not having complications or symptoms.
Notify your health care provider if you have complications or symptoms, including persistent vaginal bleeding or discharge, pelvic or groin pain or pain with sex, that last after your follow-up appointment.
Let your health care provider know you have surgical mesh, especially if you plan to have another surgery or other medical procedures.
Talk to your health care provider about any questions you may have.

If you have had POP surgery but do not know whether their surgeon used mesh, ask your health care provider at your next scheduled visit.
Dr. Michael Hulse Ob gyn Canton Ga. Falany and Hulse  avoid

Painful intercourse for both / transvaginal mesh

Side Effects of Transvaginal Mesh call 601 212 5433  more info

According to the U.S. Food and Drug Administration, the most frequent complications involving vaginal mesh used to repair fallen pelvic organs (pelvic organ prolapse) include protrusion of mesh through the vagina, pain, infection, organ perforation, bleeding, urinary problems and pain during sexual intercourse.
A recently identified additional complication of transvaginal pelvic organ prolapse repair is mesh shrinkage. Published reports link mesh shrinkage or contraction to vaginal tightening and vaginal pain.
Both vaginal mesh shrinkage and mesh erosion or protrusion may cause severe pelvic pain, painful sexual intercourse or even an inability to engage in sexual intercourse.
Any of these problems can have a profound effect on your quality of life. Many mesh complications require additional surgery and hospitalization or even repeated surgeries. And yet, the presence of a surgical mesh implant may make future surgical repairs more challenging, according to the FDA. Medical manufacturers have a duty to make products that are safe and effective when used as directed. When they produce devices that cause injury and scarring, they should be held accountable for the harm they cause.
If you have experienced problems after a vaginal mesh procedure, please understand that you are not alone. The FDA has received nearly 3,000 complaints of complications with vaginal mesh from 2008 through 2010, prompting the government to issue a health warning about transvaginal mesh risks and complications.

Dr. Michael Hulse non-responsive to vaginal mesh complications

http://www.vaginalmeshcomplication.blogspot.com/  

call me at 601 212 5433 for more info
Transvaginal surgical mesh implants or slings, which have been implanted in millions of women in urogynecologic procedures to repair pelvic organ proplase (POP) and stress urinary incontinence (SUI), have been linked to a high rate of serious mesh complications. Women throughout the country have suffered from transvaginal mesh implantation and are seeking compensation for serious injuries, including erosion and extrusion of mesh, perforation of organs, vaginal bleeding, chronic infection, pain and emotional distress.

Surgical pelvic mesh products are implanted to provide support for a woman’s organs in the pelvis, which drop, fall, bulge or protrude (prolapse) into the vaginal wall due to weakened or stretched muscles that occur from childbirth, pregnancy and other causes. In extreme cases, the vagina can even fall to the point where the vagina is outside of the body. Mesh can be placed to repair prolapse of the following pelvic organs: bladder (cystocele), top of the vagina (apical prolapse), uterus (procidentia), rectum (rectocele), bowel (enterocele) and urethra.
Stress urinary incontinence (SUI) is an involuntary loss of urine that occurs during physical activity, such as coughing, sneezing,  laughing, or exercise. Stress urinary incontinence (SUI) may occur as a result of weakened pelvic muscles that support the bladder and urethra. The condition is most common in women who have had multiple pregnancies and vaginal childbirths, and who suffer from pelvic organ prolapse (POP). The implanted mesh or sling is intended to work as a hammock which will support the prolapsed organs and to address the symptoms associated with POP and SUI.

Transvaginal and Pelvic Mesh Complications and Failures
Adverse events from pelvic mesh implanted transvaginally may include:
■Erosion of the mesh through the vaginal tissue
■Exposure or extrusion of mesh, which can require multiple surgeries
■Feeling a lump in the vaginal opening or something protruding from vagina
■Painful sexual intercourse (dyspareunia).
■Perforation or puncture of the bladder, intestines and bowels, as well as blood vessels around the vaginal wall
■Recurrent Pelvic Organ Prolapse (POP)
■Urinary problems
■Vaginal bleeding
■Vaginal chronic drainage, discharge and infections
■Vaginal pain
■Vaginal scarring and shortening
In many cases, women require surgical excision to remove the mesh or sling and may even require two or three additional surgeries. Despite removal of the mesh, complications may not be reversed, and women continue to suffer with vaginal pain and an impaired quality of life.

Posted 6 days ago by JustAskBob