Category Archives: Erosion of Mesh

Why So Many Deaths From Monarc Slings? Pelvic Mesh Disasters

The FDA received 193 reports of death after Monarc Subfacial Hammock placements—by far the highest number for a specific brand of pelvic mesh. The FDA MAUDE system admits their reports are notoriously unreliable for accurate statistics.  It isn’t inconceivable that the number is nearer to thousands because the Government Accounted Office estimated only about 1% of complications are reported. (Physicians aren’t mandated to report illnesses, deaths, or injuries.) If the one percent statistic is accurate, then 19,300 deaths have occurred. Given that 4.5 million women across the globe had pelvic mesh implants, it is entirely possible.

With the FDA’s blessings, American Medical Systems rolled out the Monarc in 2005. The half-inch wide strip of loosely-knitted, clear polypropylene monofilament sling came with two stainless steel curved needle passers with plastic-handles that looked like grappling hooks. The top of each passer is intended to grab the ends of the sling and pull it through the vagina and obturator membrane. The sling assembly also included two plastic insertion sheaths attached to the mesh and removed after placement. An absorbable tensioning suture, threaded lengthwise through the mesh, allowed the surgeon to adjust the tension before closing the surgery. AMS declared the mesh would remain in the body permanently.

Illustration used under Fair Use Act for Educational Purposes

AMS’s illustration (and it’s understanding of female anatomy?) of the obturator was pictured as a vacant space with no purpose, but in reality, it is flush with blood vessels and nerves supplying the bladder, vagina, vulva, and hips. Those were more vulnerable to injury than AMS acknowledged.

On October 15, 2014, the FDA issued a recall for Monarc sling passers along with other AMS products due to compromised sterile packaging.

If the sterile packaging was the only problem, the deaths might be predominantly due to infection, but the MAUDE death reports include autoimmune diseases like diabetes and several types of cancer (e.g., lymphoma, large and small cell, and lung cancers).

Jenny Wallace (pseudonym) traded her prolapsing bladder for urinary tract infections, pain, infection, vaginal scarring, urinary problems, adhesions, recurrence, emotional distress, apical mesh erosion, extruded vaginal mesh, and bleeding. She was implanted with a Monarc in 2008. She underwent several partial removals and, on October 24, 2010, died of metastatic small cell cancer.

More research needs to be done to determine why Monarc has so many more death reports than other products and to quantify types of death. But, for now, if you have a Monarc, you might consider having it removed by a competent removal surgeon. Fortunately, AMS no longer sells slings.

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Peggy Day is working on a book to combine all these stories. This is an excerpt from Pelvis in Flames: Your Pelvic Mesh Owner’s Guide. Your input is welcome to help make Pelvis in Flames the book you need to read.

If you’d like to join an online support group and learn about erosion, partial removals, surgeons, or just find out that you are not alone, join my group, Surgical Mesh or check the list of support groups here.

Subscribe to PelvicMeshOwnersGuide.com to learn more about pelvic mesh. I’d like to hear from you if you are helped by what you read here or if you need to know more about any particular topic. Comment below or email me privately at [email protected].

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Monarc™ Subfascial Hammock

Specialized MRI and 3D Ultrasound See Mesh – CT Can’t

Too many surgeons are sending patients to have a CT (Cat Scan) and,  when the radiologist says he/she can’t see mesh, tell the patient the mesh must have disappeared or dissolved when a CT cannot identify mesh. Plastic mesh does not dissolve. Sadly too many patients have their pain disrespected or disregarded when the problem is the doctor’s. Only specialized 3D Ultrasound with the right technician and radiologist (more on this coming in another blog soon) and specialized MRI’s with the skills to see it and read it can identify mesh.
Here is a graphic, courtesy of www.scbtmr.org that you can print out an take to your doctor.

MRI to find mesh

How to see mesh with an MRI

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Peggy Day is working on a book to combine all these stories. This is an excerpt from Pelvis in Flames: Your Pelvic Mesh Owner’s Guide. Your input is welcome to help make Pelvis in Flames the book you need to read.

If you’d like to join an online support group and learn about erosion, partial removals, surgeons, or just find out that you are not alone, join my group, Surgical Mesh or check the list of support groups here.

Subscribe to PelvicMeshOwnersGuide.com to learn more about pelvic mesh. I’d like to hear from you if you are helped by what you read here or if you need to know more about any particular topic. Comment below or email me privately at [email protected]..

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Peggy Day is working on a book to combine all these stories. This is an excerpt from Pelvis in Flames: Your Pelvic Mesh Owner’s Guide. Your input is welcome to help make Pelvis in Flames the book you need to read.

If you’d like to join an online support group and learn about erosion, partial removals, surgeons, or just find out that you are not alone, check the list of support groups here.

Subscribe to PelvicMeshOwnersGuide.com to learn more about pelvic mesh. I’d like to hear from you if you are helped by what you read here or if you need to know more about any particular topic. Comment below or email me privately at [email protected]

        • If you are helped by what you read here or if you need to know more about any particular topic, comment below or email me privately at

[email protected]

      • .

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Woman Explains Why Mesh Litigants Are Not Money-Hungry Fools

Personal Story by Dot P.*

I just responded to an extremely cocky Endo Pharmaceuticals sales representative. They aren’t the nicest, nor brightest. He was saying some pretty nasty things about one of the first surgeon to sound the alarm about mesh, Dr. Ostergard, and the women who get the mesh– how they are all just trying to have their big payday….HAH….as if.

MESH IS FOR scrubbers

Here is Sandra’s reply:
If you are a salesperson for any of these medical devices, kits, etc, you really don’t want the truth now, do you? Do you have children? Or if you are a male sales rep, do you have a wife? Knowing how disabling this mesh (and all mesh) can be would certainly give me pause. 
I would love to believe that you all really do care, but to be honest, I doubt any of you really of you do—not until it hits home.
I do believe in order to obtain the jobs you have, you must have a basic idea of biology, and how things work. If not, you shouldn’t be in this field. As corrupt as it already is, you’re not doing anyone a favor.
Now, back to your wife, or God forbid your daughter, niece, or Mom. Would you want a surgeon with so little skill that she merely attended the weekend cadaver course to learn how to implant a product that is made of the same material as a hula-hoop? There is oil in them there mesh kits.
Do you know what polypropylene does to your system? Well, it’s not inert as the makers would want you to believe. No. It shrinks, it scars, it wraps itself around really important organs like your bowel or bladder. I had mine cutting through my urethra. The surgeon had to scrape it off my bladder and, for eight hours, he tried to get that crap out because very well meaning surgeons who can implant this crap were never given a single lesson on how to take it out. Not until 155px-NWTND_bag_Page_8-1 only recently have just a handful of qualified surgeons been able to remove this crap.
Now, once again, I ask you this question: Look at your beautiful wife, daughter, or whichever female has ever meant anything to you. Would you seriously want this crap in any of them, knowing they have a 40% chance of erosion, foreign body reaction, pain that is equivalent to giving birth, having cancer, or wanting to die but knowing that dying would just hurt their babies more?
Think about what you’re doing to women. Please try to find that place where you were when you began working in this business and wanted to make a difference.
They called Dr. Ostergard a dinosaur. They tried to make him irrelevant. He’s not irrelevant. I wish that ten years ago, when I was brutally assaulted by a seemingly well-meaning surgeon, I had access to his papers. Ostergard knew the ramifications of using mesh. He tried to warn everyone yet he was laughed at. He is not laughed at all that much anymore. More enlightened surgeons are “getting it.” But, despite his warnings, Ostergard could not stop that money making machine from rolling out all over the U.S. and on into the world.
My surgeon was just “trying to help.” She had a miracle cure for me. “Hey,” she said, “it is the ‘gold standard,’” but she never mentioned what it was made of. I had the surgery because I trusted her. Then I trusted her while she operated on me unsuccessfully three more times to cut here, snip there—never removing it.
I finally found a real surgeon competent enough to remove this stuff. He likened it to removing gum from hair, or rebar from concrete. That eight-hour surgery has done little for my pain, but it’s out. My surgical report reads like someone has been brutally assaulted.
I no longer attend soccer games or honor assemblies. Once I was extremely active, now I lay in bed most of the time—only occasionally going out with my trusty walker. This is the face of mesh. It’s not too pretty. My kids will never have what I worked so very hard for them to have: A normal childhood, that’s all.
Now I ask you  one more time. Could you do this to someone you love?

*Pseudonym

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Peggy Day is working on a book to combine all these stories. This is an excerpt from Pelvis in Flames: Your Pelvic Mesh Owner’s Guide. Your input is welcome to help make Pelvis in Flames the book you need to read.

If you’d like to join an online support group and learn about erosion, partial removals, surgeons, or just find out that you are not alone, join my group, Surgical Mesh or check the list of support groups here.

Subscribe to PelvicMeshOwnersGuide.com to learn more about pelvic mesh. I’d like to hear from you if you are helped by what you read here or if you need to know more about any particular topic. Comment below or email me privately at [email protected]..

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Mesh Erosion: The Penis Fly Trap

As many as thirty or even forty  percent of pelvic mesh implantees suffer from an erosion after a mesh implantation. This is one horrific mesh problem because erosion is an extremely painful and disruptive injury. The best way to avoid it is to tell your surgeon that, under no circumstances will you agree to a mesh implant. That is very easy for me to write but a very difficult thing for a patient to do. It can be a very disheartening thing for you to read if it is too late because you already have the mesh implant, and your doctor said it is eroded and he plans to trim it up a bit or do a “midline sling incision.” Please don’t make a single decision the day he talks about that in his office. Tell him you’ll need to do some research and make another appointment. You’ve got a lot of thinking to do.

What is erosion? Erosion is a when a part of the body is “being worn away, as by friction or pressure,” in this case, by mesh. In medical studies, the term erosion is really three different complications: exposure, extrusion and perforation. Exposure is diagnosed when the mesh reveals itself to your physician. Many doctors tell a patient her mesh has not eroded because her doctor has not seen or felt it. However, mesh erodes first through the outside layers of organs and only becomes visible after it makes it way through all the protect tissue layers. Tests like pelvic examinations, cystoscopy, sigmoidoscopy, CTs, MRIs, and common ultrasound techniques are not always effective at finding a real erosion. In reality, your doctor cannot definitively say you don’t have a mesh erosion without performing surgery and examining the entire path of the sling.

Extrusion is when the mesh passes gradually out of the body structure or tissue like a loop of mesh tape found inside the vagina. (If you follow this link, there are some very graphic pictures of this injury.

Perforation is an abnormal opening into a hollow organ (e.g. vagina, bladder, rectum), most often caused by a bad implantation surgery.

MESH IS NOT FOR BODIES 5

Risk factors: Your chances of developing a mesh erosion varies greatly—from zero to 33% (depending on who conducted the medical research). Some researchers say it makes a difference whether the mesh was implanted to treat  stress urinary incontinence (younger population) or pelvic organ prolapse (older population), or whether is was implanted with a vaginal or abdominal surgical approach. If your surgeon is new to this complicated procedure, if poor technique is used, which of your surgeon’s hands is dominant, which types of mesh is used, whether or not it is coated with silicone, whether a trocar is used, your risk is higher. If you are older and your estrogen levels are lower, if your vagina is aging, if you’ve had prior vaginal surgeries, diabetes, smoke or take steroids, your risk may higher.

Treatment: You see, the manufacturers told your doctor that the best way to handle a vaginal erosion is to take a pair of scissors and cut out the bits and pieces he can see right inside his office–without so much as a shot of lidocaine, and send you home some vaginal cream to “encourage” vaginal tissue growth. The handful of surgeons who have the best success at treating erosion, including Shlomo Raz at UCLA and Dionysios Veronikis in Saint Louis, plead with patients not to let anyone cut pieces out of surgical mesh because it makes it nearly impossible to remove all of the remaining sling later on. Cutting bits and pieces leads to multiple surgeries and when complete removal is finally attempted, that surgery can take hours and hours under general anesthesia.

Your doctor probably got his mesh education in a paid weekend seminar (called cadaver clinic) or partnered up with another surgeon to do a few procedures or a sales representative scrubbed in to help with a few implant surgeries. The sales rep drops by your doctor’s office regularly to teach your doctor that he/she should cut bits and pieces of mesh. I cringe when I read women’s accounts of those procedures. They say they felt every snip of the scissors and cried out when that the mesh is clipped and the doctor just kept at it ignoring their pain. The experience was so excruciating and the women were so traumatized that they could not stop remembering that  experience for weeks, even years, after.

First-person reports of the horrors of erosions treatments, often written in private support groups online, make me wonder what became of the medical community I was once part of. Will it ever get its act together and start listening to the patients instead of the sales reps who have their own financial gain at heart and not your best interest.

Wait for the right surgeon to handle your erosion. Your pain and loss of function may make you feel like you just want to run to the closest operating room and get rid of your pain, but there are very few surgeons who will do it properly. I really recommend you take some time and find the one who will do it right the first time.

Why are they clipping? Here is some easy math: Clipping the mesh in the OR is a quick (<30 minute) income for a surgeon. If he can schedule 16 of those in one eight-hour day (and many do) he can bring in between $5,000-$32,000—an easy day’s pay. When that mesh erodes again, he gets another surgical fee—and so on and so on. The original problem, incontinence or prolapsed uterus, becomes drops to the back of the patient’s mind.

Complete removals: I’ve seen this over and over again: Women who saw surgeons who were able and willing to remove the entire mesh in one surgery have the best success and leave the support groups and get on with their lives. Patients with complete removals are not immune to repeat surgeries, but most are saying they have returned to their jobs, their families, their fun and, most importantly, the relentless pain is gone.

Partial removals: Surgeons say finding bits of mesh after a partial removal is like removing gum from hair. Bits and pieces of mesh remain behind, like shrapnel. When a doctor cuts just the parts he/she can see, the rest of the mesh springs backward and grabs onto whatever it is next to–sometimes the outside of the bladder or vagina, nerves, blood vessels, healthy tissue, and it curls and shrinks taking healthy tissue with it. The toxins in the polypropylene mesh and the bacteria colonies next to it are released into the surrounding tissues and into your bloodstream.

Lateral bladder wall with sling inadvertently placed intravesically. The patient complained of dysuria, bleeding, and urgency. Note the encrustation.

Mesh troubles begin slowly and patients are referred by their surgeons don’t address the right issue: the mesh needs to come out. All of it! When partial removals are done, women are reporting up to dozens of surgeries. Surgeons say finding bits of mesh after partial removals is like removing gum from hair or like finding shrapnel.

So, why did I name this blog Penis Fly Trap? Just imagine sex with a piece of plastic screen stretched in the middle of your vagina. It not only cuts through your delicate tissue, it cuts your mate’s penis during normal sexual movements. Husbands and lovers have been scratched, cut and scarred by eroded mesh and all too often couples have been forced to abandon intimate relations. The number of divorces among mesh-affected couples, most who started with strong healthy relationships, continues to rise as the challenge of living in the aftermath a mesh disaster becomes too much of an ordeal.

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Peggy Day is working on a book to combine all these stories. This is an excerpt from Pelvis in Flames: Your Pelvic Mesh Owner’s Guide. Your input is welcome to help make Pelvis in Flames the book you need to read.

If you’d like to join an online support group and learn about erosion, partial removals, surgeons, or just find out that you are not alone, join my group, Surgical Mesh or check the list of support groups here.

Subscribe to PelvicMeshOwnersGuide.com to learn more about pelvic mesh. I’d like to hear from you if you are helped by what you read here or if you need to know more about any particular topic. Comment below or email me privately at [email protected]..

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