More women seek surgery to relieve pain from transvaginal mesh
Published Tuesday, February 19, 2013 10:00PM EST
Last Updated Tuesday, February 19, 2013 11:20PM EST
More women are coming forward to say they are living in agony from the transvaginal plastic mesh they have had implanted to treat incontinence or complications from hysterectomies, and some are also having difficulty finding a Canadian doctor willing to remove it.
The implants have been linked to severe complications, including pain, infection and even pieces of mesh perforating internal organs, and thousands of women in Canada and the United States have filed lawsuits against the products’ makers.
Now, not only are more Canadian women complaining that the mesh is having a debilitating effect on their lives, some say they have been forced to travel to the U.S. to have it removed.
Saskatchewan resident Ruth Olson had mesh implanted in October 2011 during a hysterectomy after suffering with a leaky bladder. She said her pain began immediately after her surgery, particularly when she moved in certain ways, and it grew worse over time.
“I had pain coursing through my body,” Olson told CTV News. “Burning pains through different parts of my body. It was strange, unbelievable and inexplicable.” Olson travelled to Los Angeles to have the mesh removed.
The product was first brought to market in the 1990s to treat pelvic organ prolapse (POP), which occurs when the pelvic muscles weaken and pelvic organs -- including the bladder, the rectum and the uterus -- drop into the vagina. POP traditionally affects women after childbirth, a hysterectomy or menopause.
The mesh is inserted through the vagina to support the prolapsed organs. However, the product has been linked to a host of side effects, from organ perforation to severe pain, constipation and urinary incontinence.
Marika English, also of Saskatchewan, was in “excruciating” pain within weeks of having mesh implanted, a part of which perforated her bladder. After being left unable to work and barely able to leave her couch to use the bathroom, she, too, travelled to L.A. to have the mesh removed.
Some Canadian patients say their doctors deny that the mesh is the cause of their pain, or say they don’t know how to remove it once it becomes embedded in tissue. Some offer only partial removals.
Atlanta surgeon Dr. John Miklos says he has successfully removed mesh from more than 170 women, including a dozen from Canada.
Miklos said the operation to remove the mesh is “not for the average surgeon,” because it becomes a complicated procedure in which most of the mesh must be removed. “If it were (easy) it would already be fixed,” he said.
Stephanie Brad, a native of Saskatoon, had transvaginal mesh surgery in 2006 to treat a case of urinary incontinence. She developed complications and had surgery in Canada to repair the problems, but they didn’t help.
“Everything I do hurts. It hurts to stand, to sit, to walk. I can’t pick up my kids, I can’t hold my baby,” Said Stephanie.
So she too is turning to a surgeon in Los Angeles who reportedly has removed mesh from 500 women, from Canada and the U.S.
Stephanie hopes to raise the money for the procedure, because her home province won’t cover it. The procedure is booked for July 7.
“I hope I will have $30,000 to have that surgery. I don't know where I will get it from," she said.
However, some Canadian doctors are surprised that women are going south of the border. Dr. Jacques Corcos, a urologist at Montreal’s Jewish General Hospital and a professor of surgery at McGill University, said he and other surgeons in Canada are capable of treating patients suffering with complications from the mesh, and is “surprised” at suggestions to the contrary.
“I think each province in Canada has sufficiently well-trained physicians to do this kind of work,” Corcos told CTV.
He said patients experiencing difficulties should first see their gynecologist or urologist and the surgeon who implanted the mesh, and can then get a referral to a doctor who can remove it.
“Absolutely, no, they don’t have to leave the country,” Corcos said. “They can be treated in Canada extremely well.”
Corcos pointed out that doctors are actually seeing fewer cases of patients suffering severe complications because they have refined the procedure and are putting in less of the mesh.
However, English and other Saskatchewan patients are lobbying the provincial government to cover the estimated $30,000 cost of travelling south of the border for the surgery, saying the procedure is not available at facilities near them. Both say they are recovering slowly from the surgery to remove the mesh, which can involve removal of the outer layer of the bladder.
There are an estimated 40 manufacturers of transvaginal mesh worldwide, with between six and 10 of them available in Canada.
The complications led to warnings from both the U.S. Food and Drug Administration and Health Canada about the risk
Last spring, Johnson & Johnson announced it would stop selling four of its transvaginal mesh implants, although it said the products were not being recalled and it had confidence that they were safe.
The thousands of lawsuits filed on both sides of the border are pending, with one case in New Jersey now before a jury. A decision is expected sometime this week.
With a report from CTV’s medical specialist Avis Favaro and producer Elizabeth St. Philip