Posted August 19, 2011 - 10:05am by Tracy
Local doc chimes in on national surgical mesh debate
Pelvic organ prolapse. Although nearly half of women could experience this condition in their lifetimes, most don’t want to talk about it, many don’t want to think about it, and some are so embarrassed by it that they will not even seek out a doctor’s help.
However, this unsettling, often closeted condition has recently been brought into the national spotlight following an urgent public notice sent by the Food and Drug Administration in July. The FDA’s report warned physicians and patients about the risks of using vaginal mesh in surgical treatments for pelvic organ prolapse.
Dr. Shameem Abbasy, a urogynecologist at Swedish Covenant Hospital, said the FDA’s report is the latest factor in a debate that has been going on for years.
“When I was trained, there was not enough substantial evidence available to ensure patient safety using vaginal mesh, and there still isn’t,” she said. “Until vaginal mesh is research-backed and proven effective and safe, I won’t be using it.”
She explained that surgical mesh has long been regarded as a safe, effective, and research-backed tool in abdominal surgeries. However, in recent years some physicians have used this mesh in vaginal procedures to hold organs in place, despite the lack of solid evidence that it is safe and effective for this use. This trend has resulted in an influx of serious complications (including bleeding, infections and pain during sex) among women who were treated as such.
And Dr. Abbasy would know. Many of her patient cases are necessary solely to repair the damage done by vaginal mesh implants during previous procedures.
“Often women will tell me that they are experiencing discomfort, pain and infections, and the reason is a previous surgery which used mesh,” she said, explaining that these complications would be avoided if other treatment methods and equipment were used in the first place. Other treatment options include observation, support devices (similar to a diaphragm) and less invasive surgical procedures.
In her practice, Abbasy almost always starts a patient treatment plan with the least invasive treatment options available. When choosing a treatment, she considers many factors, including the patient’s age, sexual activity level, lifestyle and medical history.
“Treating urogynecologic conditions is unlike any other field. [Treatments] not only have to work from a medical standpoint, but also have to be totally functional for your lifestyle,” she said. “So when you see your doctor about a prolapse or incontinence, make sure you educate yourself on your options and ask questions.”
Dr. Abbasy said she hopes that the FDA’s report, continued research and better informed doctors and patients will help reduce the number of women experiencing complications after surgery.
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