Are Partial Mesh Removals the Answer? (to Mesh Complications)

By DebCNY • 2016/01/24

Dr. Ralph Zipper on Mesh Complications, and Partial Removals

I just saw this vid, and website from Dr. Zipper, on vaginal mesh removal: 

There was also this video, I found interesting about vaginal mesh complications:

I should say upfront that I am not a patient of Dr. Zipper, and am not familiar with his practice firsthand.  I’m thankful to hear that he does not use transvaginal mesh, and that he is trying to help women with complications.  That alone is huge.  So many doctors are STILL using and promoting the use of mesh, even though, they know they can not remove it if/when there are complications.  Dr. Zipper is at least not still putting mesh in, and acknowledges how serious complications can be.  He certainly sounds like a compassionate doctor.

However, I’m concerned that he is recommending partial removals, or even a “release” (basically, snip the mesh to release tension) as the best treatment.  He even makes it sound like this is not a big deal, stating that:

“Trans-vaginal mesh excision is an approximately fifteen minute procedure. The following day you can drive and return to work.”

~ Dr. Ralph Zipper website: http://www.zipperurogyn.com/treatments/vaginal-mesh-removal/

I’m also concerned that he seems to be stating that “full mesh removal” is not possible, too risky, and therefore not recommended.

Most Doctors Only Offer Partial Removals

Dr. Zipper is certainly not alone.  It seems that MOST doctors will only offer a partial removal when someone presents with mesh complications.  Many say full mesh removal is too risky and therefore not recommended.  That is what my local expert told me… and in this video, that is also what Dr. Zipper says, stating:

“…unfortunately, the entire mesh can’t be removed. And, anyone trying to do that is more likely going to create new problems for you.”

~ Dr. Ralph Zipper, in: https://vimeo.com/119582682

Is this true? Or is this just this doctor’s opinion?

Are Partial Removals the Answer to Mesh Complications?

As someone who has had full mesh removal, I personally disagree.  I also believe many others who had partial removals…. as well as those who had full mesh removals (or as close to full removal as possible) would also disagree.

That was why I wrote this post a while back, “Partial vs. Full Mesh Removal” (https://meshmenot.wordpress.com/2014/11/23/partial-vs-full-mesh-removal-surgery), which included:

“Women suffering from mesh complications often have difficulty finding a doctor who will acknowledge that their pain IS being caused by the mesh.  When their pain and problems are finally acknowledged as being mesh-related (often when the doctor can actually visibly see the mesh eroding into their vaginal wall and there is NO denying it), what they are usually offered as treatment is a “partial removal”, or a “revision”.”

and, I went on to say:

“Initially, one local doctor told me they would remove my mesh, and didn’t blame me for wanting it removed.   At first, I was so relieved.  However, when I started asking questions, they told me they would only remove the middle portion of the sling. They said, it was “impossible” to remove the parts down in my thigh/groin, which was where my pain stemmed from.    I didn’t see how removing just a small piece in the middle would help me.  Especially when I  did not have vaginal erosion (yet) or vaginal pain.  The doctor also did not sound so sure it would help, but made it sound like no big deal and we could “try it”.  Well, I not only didn’t see how it would help, but I feared it could make things worse.   When I told my doctor I had heard of some doctors doing full mesh removal,  and mentioned Dr. Raz, the doctor said they had heard of Dr. Raz, but that THEY thought it was too dangerous, and would not recommend it.     Well, there’s a big difference between “impossible”, and something they don’t personally recommend, isn’t there?”

~ from  “Partial vs. Full Mesh Removal” , please read the full post for more information.

 

I feel like most people that I’ve heard from in the support groups (listed below) who had a partial removal will say the partial removal may have helped them initially, short-term, but then they wound up having more mesh erosion, worse complications, more pain, and ultimately more surgeries.

Those who I have talked to that had full mesh removals by Dr. Raz, like myself, will say the removal surgery was not easy, but that it was wroth it.  It IS major surgery to remove mesh that has eroded and, well meshed, into nerves, organs, muscles, throughout the groin, etc.   They certainly could NOT go back to work the next day.  Often, people waited long periods of time, and traveled far distances to go to a doctor doing full removal.  However, they will also say they had relief afterwards, and it was worth it to get the mesh out – finally.  Many will even go as far as to say that full removal by Dr. Raz saved their life.  Unfortunately, no doctor is perfect…  and sometimes, there is permanent damage that occurs well before the full mesh removal surgery – and full recovery may not be  possible.

 

Full mesh removal may be risky… especially if you do NOT go to a very experienced doctor that has done many full removals – but leaving the mesh in is also risky.

The remaining mesh can keep eroding (cutting) into other tissues, nerves, etc., causing further (possibly much worse) damage.   Many women have problems with their colons, or urethras being perforated, FBR, inflammation, infections, and autoimmune issues.  These are not the kinds of problems that just go away on their own. Instead, they keep snow-balling into more problems.

If you are going to look into FULL mesh removal  – please do your homework.  Full removal IS a complicated and difficult surgery, and if done by someone not experienced, it very well COULD lead to more complications.  However, the few doctors that ARE specializing in removal, will usually say that removing all of the mesh, or as much as possible, is best chance for relief and recovery.  These expert doctors, like Dr. Raz at UCLA, and Dr. Veronikis in St. Loius, are in high demand also.  By the time many of their patients get to them, they have already undergone partial removals, and their health has continued to decline. These doctors have said that the more partial removals that have been done, the harder it is to find and remove the remaining mesh. Often, by then, there is also permanent damage.

Please talk to others that are going through mesh complications first-hand.  Try asking around in the support groups listed below.  Ask them about what they have gone through?  If they have had any partial removals? How they are doing as a result?

It is nothing short of horrifying what many are dealing with.

As I also mentioned in my other post:

“I know that there is not one cookie-cutter answer that will work for everyone and while I highly recommend full mesh removal, and Dr. Raz, I also recognize that everyone is different.   Perhaps, in some cases partial removal IS the best option.  ??  However, unless I heard that from an expert, who also believed in and was capable of doing FULL mesh removals, I would question that opinion.   You have to remember, the doctors are also being mislead by the mesh manufacturers, and they also do not have all the answers.

In the end you have to make your own (hopefully educated) decision, and go with the doctor and treatment that seems will be the best fit for you.”

~ from  “Partial vs. Full Mesh Removal” , please read the full post for more information.

 

Have you had Partial or Full Mesh removal??

I would like to hear from you.  I would like to know your take on this, because most of the folks that I have heard from in the support groups (listed below) do NOT seem to believe that a partial removal was the answer – even though that IS what most doctors seem to recommend/do.

I am very open to hearing other people’s opinions and experiences.  So, if you have  had success with a partial removal…. (or full removal for that matter)… please share here, and/or in the groups.  While I would be surprised, I would also actually be happy if I heard more people felt that partial removals helped them.  That would be great, but it simply is not what I’ve been hearing from most.  So, please share your stories.

Thank you!

Deb

==============Support Groups================

Perhaps even more helpful than articles, is talking to a variety of others who are suffering from mesh complications, and are in various stages of treatment.   Three of the larger support groups I found helpful are: 

• Women’s POP/SUI TVMesh Complications Support (Closed Group)
• Fighters And Survivors of All Transvaginal Mesh And Hernia Mesh/Plugs (Closed Group)
• Mesh Problems (PUBLIC/OPEN TO ALL, including doctors, etc)

==============Related Mesh Me Not Blog Posts================

• Finding the Right Doctor for Surgical Mesh Complications
• Why I Went All the Way to UCLA for Mesh Removal Surgery
• Searching for Docs Experienced with FULL Mesh Removal, and/or NON-Mesh Repairs
• Partial vs. Full Mesh Removal Surgery
• Upstate NY Support for Mesh Complications
• Mesh-Injured People: NOT rare. NOT going away. NOT getting SUPPORT!
• It’s NOT enough. We need help!
• Are you a GOOD mesh? Or a BAD mesh?
• Were you told that you were the “only one”?
• FDA warns there is NO evidence that mesh provided any greater clinical benefit than non-mesh surgeries
• Top 10 Things to Know About Mesh BEFORE Having Surgery for POP or SUI
• Links to many other articles, blogs, support groups, and resources on the bottom of this blog

Tagged as: Bladder Prolapse, doctors, Dr. Ralph Zipper, Dr. Zipper, full mesh removal, mesh complications, partial mesh removal, partial vs full removal, Pelvic Organ Prolapse, POP, Ralph Zipper, risk factors, Risks, Stress Urinary Incontinence, SUI, surgical mesh

Categorised in: Doctors Who Don't Use Mesh, Mesh Complications, Mesh Removal

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