09 5 / 2012

Medical Advancements: An Advantage to the Elderly?

The market-driven healthcare environment tend to show how much of the general public is being taken by the convincing strategies of  thriving health industry companies, medical journals report. It is even more intimidating to know that all medical devices available in health departments had been cleared by the questioned 510 (k) review process. These concerns have roused House members into submitting a bill to reform FDA loophole based on vaginal mesh and other medical devices.

Truly, the health care system has changed a lot over the past years, and the aging population has benefited much from these technological advances. Most of these medical discoveries have enabled the elderly and many frail patients to battle chronic diseases and physical alterations related to the aging process. However, studies have also revealed how much the cost of health care has risen over the years, and is even deemed to further grow as new medical tools and interventions are developed. With the expected medical needs of the elderly, are these costly medical advancements really helping?

Based on Erik Erikson’s developmental theory, adults aging 60 and up confronts life situations that challenge them to attain ego integrity. During this period, they will reflect on their accomplishments and slowly accept all positive and negative experiences they have handled and consider each of them as part of their lives. This is why they often like telling stories of their past every chance they get. For some who often shares experiences of missed opportunities and unresolved problems, despair may slowly set in. Those around them need to know how much the presence of family and relatives makes it easier for them to live through the remaining years of their lives with contentment. However, apart from their social needs, the physiologic changes that come with increasing age also require great care and attention that medical devices alone cannot provide.

Numerous lifestyle adjustments must be made to accommodate the elderly’s declining health. Problems like memory impairment, depression, susceptibility to all types of infections, injuries and falls, mobility limitations, generalized weakness, elimination difficulties, sleeping irregularities, and reduced exercise tolerance among many others are expected to surface. Chronic heart conditions, bone problems, and incontinence may also materialize as the body further weakens.

Vaginal Mesh Side effects

Perhaps, the innovative and market oriented health care improvements have been useful to alleviate the discomforts of the elderly. However, these advancements have brought sufferings and injuries to some, and even led to indictments like the increasing number of transvaginal mesh lawsuit.

References:

allnurses.com/critical-care-nursing/limiting-medical-care-705900.html

allhealth.org/briefingmaterials/Goldman_Final-388.pdf

agingcare.com/Answers/What-are-some-of-the-most-common-issues-facing-the-elderly—102224.htm

14 3 / 2012

What is it about Mesh that Causes Complications in POP Repair?

You may have finally talked to your primary physician or your trusted gynecologist about your pelvic Organ Prolapse Symptoms. At the start, you feel like everything is going to be fine and that all these awful symptoms you have been experiencing for some time will soon go away. Then your doctor opens up the possibility of a mesh implantation.

 

Of course, after all the buzz going on around the mainstream media lately, no woman who has heard this deafening news would think a synthetic mesh would be a safe option. After the FDA intervened in the rising mesh controversy, women who have had these mesh materials implanted in them are starting to come out and share their individual experiences about its complications and how badly it had affected their lives in all angles.

 

Whether you have just found out that you need surgery for your prolapse, scheduled for a procedure and now concerned about its possible outcome because mesh implantation was already planned, or already out from surgery and the thought of mesh complications hang around in your mind lately, you are not alone in this dilemma. There are millions of women all over the world that is feeling exactly the way you feel. You should know, however, that like all of them, you have the right to know all the other treatments available for your condition. But, of course, your case is unique from all the others. You have to find a doctor you are most comfortable with to help you weigh your options before proceeding with this type of procedure.

 

One root of complications has been the use of the mesh. Others feel it has to be the mesh material that is mostly causing the reaction. Some people develop hypersensitivity to the substance called polypropylene, which makes up most of the meshes. But, you should know that this is not the first time mesh has been used for surgery. Since the ancient days, the mesh has been practically utilized for the correction of hiatus hernia, abdominal hernia, and chest wall reconstruction among others.

 

Furthermore, the mesh in POP may be inserted through the abdomen or the vagina. In abdominal procedures, there are lesser complications reported than with vaginal implantations. It is the vaginal mesh implants that both women and physician are worried about, since many complaints have lately been reported.

 

There is a thin line between having a successful vaginal mesh implantation and having complications. Factors like mesh quality, implantation site, and mesh size play major roles in the success of a transvaginal mesh placement. Almost all these depend largely on your doctor’s experience and skills with this type of operation.

 Pelvic Organ Prolapse Evaluation

The U.S. FDA, together with all the other concerned individuals, believes that doctors should also be responsible in using mesh on the right patient and under the right circumstances. They should also consider using non-mesh procedures first before resorting to the use of mesh. The issues on vaginal mesh lawsuit are still climbing in numbers. Therefore, to avoid any of these in the future, do not hesitate to ask your doctor for any non-surgical options that applies to your condition.

References:


healthywomen.org/condition/pelvic-organ-prolapse

surgicalmesh.com/pp_mesh.htm

pelvicfloordysfunction.com/

31 1 / 2012

Pelvic Organ Prolapse (POP) and Stress Urinary Incontinence (SUI)

Practiced worldwide by many surgeons as treatment for Pelvic Organ Prolapse (POP) and Stress Urinary Incontinence (SUI), vaginal mesh surgery has been well known since the 1990’s. It refers to the implantation of a medical device called vaginal mesh into the vaginal wall to strengthen the pelvic muscles and to provide a better support for the pelvic organs.

 

Pelvic Organ Prolapse (POP) is defined as the shifting of the organs in the pelvic region from their respective positions resulting from the weakening of the series of connective tissues that support the vaginal wall. There are different kinds of prolapse, and the most common are: bladder prolapse, urethrocele (prolapse of the urethra), uterine prolapse, and rectocele (prolapse of the rectum). Among the many types of prolapse, these are the most frequent to be developed: rectocele (prolapse of the rectum), urethrocele (prolapse of the urethra), bladder prolapse, and uterine prolapse. Stress Urinary Incontinence (SUI) is known as the uncontrollable leaking of urine from the bladder in involuntarily induced movements like coughing or sneezing. This is most likely to develop from weakened pelvic muscles. POP and SUI both frequently occur to old women with weakened vaginal walls like in menopause, previous hysterectomy, and vaginal deliveries.

 

How do surgeons carry out this procedure? Firstly, an incision is made to gain access inside the vagina, and then the tissues that support the vaginal wall will be strengthened with stitches. A vaginal mesh is then inserted firmly under the vaginal skin and stitched intact. Designed with many holes, this medical device allows the body tissues to easily grow into it 3 to 4 weeks later. The incision made to the vagina earlier is then stitched back to close. An additional stitch at the top of the vagina or the cervix (sacrospinous stitch) may be required by some doctors for stronger support. However, patient may feel discomfort in the buttocks that could persist for 3 months if this stitch is done At the end of the surgery, a urinary catheter and a vaginal pack are inserted in place, and may be pulled out after one to two days.

 

Deadly complications associated with this surgery are most likely to happen, so careful observations should be done during the surgery and the recovery phase. Recently, increasing number of complaints from vaginal mesh recipients has flooded the U.S. Food and Drug Administration (FDA). The most common reported complications are: mesh erosion, bleeding, infection, recurrence of prolapse, urinary problems, and pelvic organ perforations. These complications are deceiving since they start as mild symptoms, but they are attributed to greater and more serious negative effects. Some of these complications are hard to manage, and some have even led to patient’s death. In fact, because of these deadly complications thousands of lawsuits were filed by many recipients against mesh manufacturers all over the United States recently.

 

If you are one of those women considering vaginal mesh surgery for the management of POP or SUI, or if you know someone who is planning to receive this treatment, ask your doctor detailed information about your surgery, most importantly about the possible complications this procedure may bring about.

21 12 / 2011

Vaginal Mesh Surgery

Many women worldwide are experiencing Organ Prolapse (POP) and Stress Urinary Incontinence (SUI), which are two harmful conditions.    These conditions may bring discomfort and pain, but when managed properly they don’t aggravate.  These medical conditions mostly happen to adult women and those who have had vaginal deliveries. 

The vaginal wall is enveloped by a system of connective tissues that functions as a support mechanism for the pelvic organs.    These connective tissues stretch and weaken resulting to the displacement of the pelvic organs in POP and SUI.   Symptoms include a sense of pressure in the wall of the vagina or groin area, pain on the lower back, constipation, pain during sexual intercourse, and the inability to control urination.

A trans-vaginal mesh (TVM) surgery, which is only indicated for symptomatic patients, is then performed.   A medical device called vaginal mesh is anchored into the vaginal wall to reinforce support of the vaginal area in POP and the urethra in SUI.  Implantation of the Vaginal Mesh can pose dangerous complications, so management of this procedure should be done with caution.  The harmful complications related to this procedure should be considered and explained by doctors to their patients.  There is a need of an informed consent from the patient to ensure that they are aware of the possible risks of the procedure. 

So, what happens during the surgery?   Spinal or general anesthesia is administered; then the doctor begins with an incision inside the vagina where the prolapse is, and stitches the vaginal wall for a better support.   The vaginal mesh is implanted under the vaginal skin and anchored securely in place by stitches.  The surgical mesh has holes that body tissues could easily grow into after 2 to 4 weeks. It provides reinforcement to the vaginal tissues.   The physician then stitches the incision that was previously made in the vagina. An additional stitch called sacrospinous stitch may be done into the cervix or at the top of the vagina for a better support. For a stronger support,  sacrospinous stitch is done at the top of the vagina or into the cervix.  Patients might experience discomfort in the buttock for up to 3 months after the surgery with the final sacrospinous stitch.  The last step of the procedure is the insertion of a catheter and a vaginal pack; the catheter is inserted into the bladder for proper urine drainage and the vaginal pack is inserted into the vagina to avoid bleeding complications. These stay in place for a day or two. 

A number of physicians suggest using a vaginal support device (VSD)to insert into the vagina after the procedure. This device, which is made of soft material, gives additional support in the vaginal wall during the recovery stage.  It is then removed 4 weeks post-surgery. 

After the surgery, pain medication and antibiotics are prescribed by the physicians.  There is also the need to avoid any strenuous activities for 6 to 12 weeks. 

Complications like bleeding, infection, and pulmonary embolism can occur during the surgical procedure.  An informed consent is needed since these complications can be deadly.   Be aware of the possible dangers of this procedure by asking your doctor to explain them to you.

References:

*http://www.anapolschwartz.com/practices/transvaginal/transvaginal-mesh-procedure.asp

*http://www.thewomens.org.au/Meshinvaginalprolapsesurgery

*http://www.medscape.com/viewarticle/705592_13