More consequences of mesh rectopexy

Hi, everybody,

For the last several months have been having constant clear vaginal discharge and have to wear a pad. Went and had an ultrasound, turns out the scars from the mesh rectopexy have blocked my falopian tube and fluid builds up in it and leaks through the vagina. They call it hydrosalpinx. Also found this great article how pelvic surgery damages the nerves and causes pain - even some treatment has been proposed.

possover.com/files/media/de...

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  • The report is actually very specific for pelvic organ prolapse surgery and cannot necessarily be applied to other types of pelvic surgery. There are several other problems with this report:

    1) It is only a very small sample size which makes it extremely difficult to reach any proper conclusions as to whether the surgery is at fault or if these patients would/are particularly susceptible to nerve damage due to other conditions present or treated in the past such as deep infiltrating endometriosis or simply because of their genetic makeup

    2) At this centre they are likely to see more patients referred to them for complex conditions that can't be treated at local centres both in Zurich or in other countries - i.e. endometriosis affecting the nerves. The more complex a surgery is the greater the potential risk of complications there is, although relatively minor procedures could result in these types of complications in a few people

    This is why it's so important to look at the numbers of this type of surgery being performed every year - these figures are hypothetical and chosen at random but if 200,000 patients a year in the U.K. undergo prolapse surgery and 92 patients have confirmed nerve damage this is a very small number of patients with this problem.

    Another problem I have is that anyone reading this needs to be aware that chronic pelvic pain or chronic pain generally results in central sensitisation - pain changes the way the central nervous system works so that someone feels more pain from the lightest touch. This isn't the same as nerve damage. Central sensitisation is very common whereas nerve damage is considered relatively rare. Most people with chronic pelvic pain will also have an element of Central sensitisation - I have this diagnosed by the pain clinic. Central sensitisation can be seen as a secondary diagnosis to the original diagnosis i.e. I have endometriosis, adenomyosis and IC/BPS which are my medical/primary diagnoses- central sensitisation was diagnosed as a result of these conditions causing chronic pain and is therefore secondary. The conditions cause pain in there own right but the CNS 'overreacts' to the level of pain actually experienced - pain might really be a 6/7 out of 10 but overtime the CNS interprets the pain to be 10/10. The extent that someone will experience the phenomenon of central sensitisation is again highly individual so it is extremely difficult to say but some people maybe more prone to this than others. There are chapters in medical books or patient information leaflets on pain that contain further information on the central sensitisation if anyone is interested. Physiotherapists are some of the most educated in the U.K. When it comes to pain as they spend a huge amount of time learning about pain during their undergraduate degree and I'm sure if anyone is under the care of a physiotherapist at the moment their physiotherapist might be able to signpost them to further information

    Prof Marc Possover who runs the Possover Medical Centre is an extremely well respected medical professional. But I felt it important to flag up the limitations of this report so that GPs and other health care providers don't become bombarded with patients suspecting nerve damage or more importantly people on here don't become worried

  • Entrapped nerves from pelvic surgery is a well known condition, obviously inserting a mesh would increase the risk. I think it is a glimpse of hope for sufferer. In UK the only option available is Mrs Eilneil and a few other surgeons removing the mesh but it does not always help, there was a recent BBC broadcast on the matter and a publication in Daily Mail. I would suspect that It is extremely expensive to have surgery in Zurich otherwise the numbers in the article would be higher.

  • I'm aware of that and the consultant you mention, however the report you have posted is in relation to prolapse surgery which doesn't always use mesh. There is no indication that the expense of the surgery has affected the number of participants involved in the study, some studies do due to their nature have smaller participant numbers, but for a study to be meaningful it should have studies published elsewhere by other research groups that support these findings completely - the study didn't involve just mesh. I actually know a person who had surgery for sciatic nerve endometriosis by Prof Possover and was extremely happy - she is by no means rich and found the money charged very reasonable. Nerve entrapment is not commonly seen in pelvic surgery generally and it is simply wrong to suggest this - there are many types of surgery in the pelvis carried out each year - hysterectomy, endometriosis, adenomyosis, bladder surgeries including removal, etc. If it was commonly seen in pelvic surgery these figures for nerve injuries would be far far higher than what is seen in clinical practice. You are using this study to suggest that mesh for prolapse creates injuries in everyone. This simply isn't the case and it relates more to the type of mesh used rather than to all mesh - it seems that synthetic mesh is the biggest culprit. Injury to nerves is a risk with any surgery - it should always be mentioned or asked about during pre ops or before having the surgery with the surgeon. Patients with entrapment are still are risk of central sensitisation as is everyone with chronic pain of any type. When using evidence to support a point it is best to use information from nhs, journals rather than newspapers who often will report on a health topic according to biases for the paper and journalist writing them. I for one am not a fan of this paper as it has frequently gotten conditions wrong or simply misrepresented the facts - an example is with endometriosis which caused a lot of upset in those with endometriosis. There is a problem in some people but not everyone with mesh and we do need to be clear on this.

  • I really have no such points and did not make any assumptions. This article was found by a friend of mine who is looking high and low for help with excruciating pain after mesh rectopexy so I decided to share as it provides some hope. I was about to die from pain after my biologic mesh rectopexy and the consultant who did it told me that I have nerve entrapment everywhere however it is above his abilities to do anything and I am on my own. He can't find my ureters in the scars let alone the nerves. If I new that Possover is dealing with this problems after mesh rectopexy I would have gone to him.

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