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Surgical mesh issues 'literally destroying lives'
Jun 3, 2016 | Radio New Zealand
Tracking surgical mesh devices would be a partial victory for those dealing with the mesh's painful complications, but doesn't go nearly far enough for sufferers. Surgical mesh is a net-like implant used to treat pelvic organ prolapse and urinary incontinence in women - as well as bowel prolapse and hernia repairs. -
Woman faces long health battle after surgical mesh operation
Jun 1, 2016 | Stuff
By Samantha Gee
What began as routine surgery to relieve incontinence has resulted in 11 years of debilitating infections for Motueka woman Susan Waters. The naturopath and former nurse had surgery in 2003 to insert surgical mesh to alleviate the stress incontinence she suffered after childbirth. -
To pee, or not to pee: Pelvic prolapse is common and treatable
Jun 2, 2016 | Richmond County Daily Journal
By Dr. Janet Harris-Hicks
As women age and experience childbirth, as well as other strenuous physical activities, certain muscle groups aren’t as strong as they used to be. A woman’s pelvic floor – the muscle group responsible for supporting the pelvic organs – can weaken due to aging, injury, physical exertion or certain illnesses, leading to a condition known as pelvic organ prolapse.
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Surgical mesh issues 'literally destroying lives'
Jun 3, 2016 | Radio New Zealand
Tracking surgical mesh devices would be a partial victory for those dealing with the mesh's painful complications, but doesn't go nearly far enough for sufferers.
Surgical mesh is a net-like implant used to treat pelvic organ prolapse and urinary incontinence in women - as well as bowel prolapse and hernia repairs.
Complications from use of the mesh has been the subject of more than 200 ACC claims between 2010 and 2014, with ACC paying out more than $2 million in treatment, rehabilitation and compensation.
After considering a petition brought by two women who suffered serious complications from mesh implants, Parliament's Health Select Committee has now recommended that a national register to track the devices should be established.
Charlotte Korte - one of the women behind the petition - told Nine To Noontoday that the committee had made some good recommendations and was following overseas initiatives, but had not gone far enough.
"There really isn't a lot of help for the system capability, and that's helping the patients that suffering from mesh complications now.
"Their lives are literally destroyed, they live in chronic pain, they are unable to function in normal everyday life and the biggest problem is being able to access doctors that can actually fully remove mesh. Many patients are undergoing partial removals, which are not working, and in many cases making it a lot worse, and with the limited skill base in New Zealand, there is no help for them at this stage."
She said other issues that still needed to be addressed included doctors not filling out the ACC forms that enabled sufferers to get help, issues of ethics around doctors implanting permanent mesh that they could not remove, and the problem of informed consent.
"We're still hearing from patients that have absolutely no idea of the potential complications. We've seen advertising for incontinence procedures in magazines saying it is a simple operation and a quick fix. These simple operations are causing so many problems, and the whole informed consent process needs to be changed."
She said doctors were being misled by the manufacturers, and the ethics and morals displayed by the makers needed to be investigated.
"I think doctors should be concerned when using these devices. There needs to be more investigation of how these devices get on to the market and are they actually safe."
The select committee's report said Medsafe did not believe a registry would improve patient safety.
It also noted a registry would be expensive to establish and maintain and could cause unnecessary worry for patients.
But Ms Korte rejected that idea.
"I think there is a lot of worry out there anyway, and I think a registry is going to stop those concerns."
Dr Hanifa Koya - a gynaecologist at Wellington's Wakefield hospital who has removed more than 50 surgical mesh implants from patients - said there were already registries for things such as hip replacements, and the recommendation of a registry for mesh was long overdue.
"A lot of harm has been done, and we need to accept that a lot of harm has been done."
Dr Koya said with sufferers in New Zealand unable to take a class action against the mesh manufacturers, a registry was vital.
Hospitals also needed to go back to having an ethics committee, and the role of Medsafe in the issue also needed to be examined, Dr Koya told Nine To Noon.
http://www.radionz.co.nz/news/national/305518/surgical-mesh-issues-'literally-destroying-lives'
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Woman faces long health battle after surgical mesh operation
Jun 1, 2016 | Stuff
By Samantha Gee
What began as routine surgery to relieve incontinence has resulted in 11 years of debilitating infections for Motueka woman Susan Waters.
The naturopath and former nurse had surgery in 2003 to insert surgical mesh to alleviate the stress incontinence she suffered after childbirth.
ACC have denied Waters health complications are a treatment injury resulting from the insertion of the surgical mesh and she is now trying to raise $50,000 for treatment in the United States to remove it.
Waters is one of hundreds of Kiwis who have reported severe health problems after the insertion of surgical mesh, which is used to support weakened structures after pelvic organ prolapse, stress incontinence and hernias and there are currently a lack of specialists in New Zealand with the expertise to remove it.
A few months after the operation, Waters began to get recurring bladder infections and which then turned into kidney infections that required hospitalisation for intravenous antibiotics.
When Waters is really ill, even getting out of bed is a marathon effort.
"It is like you are drunk and debilitated," she said. "I know that seems ridiculous but that is how sick I get, I think 'am I going to get out of it this time'?"
She now has to take antibiotics daily and as they lose their effectiveness, she is at risk of dying from an infection.
Waters had no health problems until the surgery, but now has a stack of papers that make up her medical file, telling of countless hospital visits, numerous appointments with specialists and several corrective surgeries to fix the problems she is suffering from.
Corrective surgery to cut the mesh did not alleviate the infections and a rectal repair resulted in paralysis in one of her legs for six months, before subsequent surgery to cut a stitch meant she was able to get the feeling back.
Over the years, the cause of Waters' health issues were not clear and she spent thousands of dollars on further testing. A urologist in Christchurch revealed her bladder was partially obstructed, she had higher than normal bladder pressure and low emptying flow which caused frequent infections.
"It took quite a while and a lot of money to prove that, in amongst me being sick all the time."
Waters has battled ACC who declined her treatment injury claim, despite her evidence that the mesh is causing her problems and that seeking private treatment is her only option.
A Medsafe report in October said 91 adverse events had been recorded since 2005 relating to surgical mesh and stress urinary incontinence devices.
However an ACC review in 2015 found 466 treatment claims had been received relating to the use of surgical mesh between 2005 and 2014.
The Medsafe report showed 56,187 devices were supplied in New Zealand between January 2005 and October 2014, but it was impossible to know how many had been implanted in people.
Last July, Carmel Berry and Charlotte Korte, who are both suffering complications caused by surgical mesh, appeared in front of Parliament's health select committee to present evidence to support their petition for a commission of inquiry.
Green Party MP Kevin Hague said the committee had heard from several people who had been affected by complications resulting from operations using surgical mesh and a report on the matter was expected to be published this week.
"We have certainly heard evidence from people who have talked about substantial experience of pain and discomfort and the ordinary functions of life becoming impossible," Hague said.
"Very clearly there are people who need surgical mesh removed and it's essential that the New Zealand health system provides timely access to that service."
Hague said there was currently no process for approving the safety of surgical mesh, which was considered a surgical device prior to its use in New Zealand and there were limited options available to those when it proved problematic.
The petitioners had called for a moratorium on the use of mesh, saying that it should no longer be used in New Zealand.
Hague, who is also the Green Party's ACC spokesman, said that ACC needed to step up to the mark. "For someone who has a treatment injury from the use of mesh there is no question that, that should be covered by ACC," Hague said. "Here is a group of people who very clearly are experiencing substantial pain and disability as a result of treatment injury, ACC needs to do its job."
ACC senior media advisor Stephanie Melville said treatment injury claims were complicated and required expert advice from appropriate medical specialists.
"Once all the necessary information has been assessed ACC can then make an informed decision. It is in situations where the independent medical specialists find no direct causal link between the treatment and ongoing incapacity that ACC is unable to provide cover. However, ACC is always be happy to reconsider a claim if a person has new medical information."
Melville said the specifics of Waters' case could not be addressed because no authority had been given to discuss the claim.
While some types of surgical mesh can be removed in New Zealand, no-one here has the expertise to cut out the type of "tape bladder sling" that Waters has.
She is now waiting for a quote for the cost of treatment in the United States and is working out how to fund the treatment and trip expenses which is estimated to cost $50,000.
She had made an application to withdraw her Kiwisaver funds under the serious illness clause and would most likely have to take out a personal loan.
A group of her friends have organised several fundraisers and a Givealittle page started for Waters has raised more than $6000 to go towards her treatment.
http://www.stuff.co.nz/national/health/80538067/Woman-faces-long-health-battle-after-surgical-mesh-operation
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To pee, or not to pee: Pelvic prolapse is common and treatable
Jun 2, 2016 | Richmond County Daily Journal
By Dr. Janet Harris-Hicks
As women age and experience childbirth, as well as other strenuous physical activities, certain muscle groups aren’t as strong as they used to be. A woman’s pelvic floor – the muscle group responsible for supporting the pelvic organs – can weaken due to aging, injury, physical exertion or certain illnesses, leading to a condition known as pelvic organ prolapse.
Healthy pelvic muscles and connective tissue form a sling across the opening of the pelvis, which holds the bladder, urethra, uterus, vagina, small intestine and rectum in place. When these muscles are stretched, weakened or injured, they can no longer support the pelvic organs. Urinary leakage can result.
Pelvic organ prolapse refers to the dropping of one or more of these organs from its usual position in a woman’s body, which can result in chronic pain and discomfort, anxiety, incontinence, and possible infection. These organs can descend from their normal location in the abdomen and push or bulge against the walls of the vagina, or, in severe cases, actually protrude from the pelvic area.
The condition is common. Health experts estimate that nearly half of all women over age 50 have some type of pelvic organ prolapse, but only a small percentage of affected women seek medical help, either due to embarrassment or assuming their problem is a natural consequence of aging.
The most common causes of pelvic organ prolapse are childbirth, a hysterectomy, or intense physical activity, such as lifelong participation in high-impact sports (involving running or jumping). A woman’s likelihood of developing pelvic organ prolapse also depends on her genetic background and her own unique anatomy. Women who have weak ligaments are more prone to prolapse problems than those who naturally have stronger ligaments. The condition tends to run in families, and women who have had a vaginal childbirth have a slightly higher risk than women who delivered a baby by cesarean section. Other causes include:
• Obesity
• Smoking and lung conditions that cause chronic coughing
• Occupations that require heavy lifting
• Frequent constipation
• Age (risk goes up after menopause)
• Illnesses or diseases such as multiple sclerosis, muscular dystrophy, or a spinal cord injury
Some women do not experience noticeable symptoms in the early stages of prolapse, but as the condition progresses, symptoms can include pressure, fullness or pain in the lower belly or vaginal area; pain in the groin or lower back area; irritation and/or bleeding from exposed skin; stress incontinence (urination during coughing, sneezing or laughing); pain during intercourse; or difficulty with urination or bowel movements.
Pelvic organ prolapse is not life-threatening, and treatment varies, depending on a woman’s symptoms, age and childbearing status (i.e., if she has already had or plans to have children). The condition is generally diagnosed through a pelvic exam and medical history, with a focus on past pregnancies, health problems, and level of physical activity or injuries.
Lifestyle changes can relieve mild symptoms, and include weight loss, medications, pelvic exercises (i.e., Kegel exercises), and dietary changes. A removable device called a pessary offers a non-surgical solution, and can be inserted into the vagina to hold the pelvic organs in place. For more severe symptoms, surgery can repair the supportive tissue around the prolapsed organ.
June is Pelvic Organ Prolapse awareness month. It is an annual campaign to increase awareness of pelvic organ prolapse.
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