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When you have been injured in a car accident, you will need a doctor that will accept your PIP insurance and an experienced personal injury auto accident lawyer.

Our Injury lawyers in  Pompano Beach have handled 100's of  automobile accident injury cases. We help injured automobile accident victims in Pompano Beach, Margate, Coral Springs and all of the 954 area code. .

With the increase in the number of lawyer advertisements  in Broward County fighting for your auto accident claim, it may be hard to know what to do.

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Vaginal mesh Updates, Vaginal Mesh lawyers, Vaginal mesh Doctors, Everyone is in on It

The Vaginal mesh has been the center of attention these days with lawyers on T.V and doctors trying to give women hope and confidence again. Women are filing lawsuits for defective devices and J & J has pulled four of the Gynecare mesh off the market. The mesh is a problem. At the  vaginal mesh helpline,  women are getting support and help by a female medical social worker who is attempting to locate a urogynecologist or surgeon for them with much difficulty. The vaginal mesh helpline also put women in touch with a lead lawyer or a lawyer who only refers to a lead lawyer approved by the helpline. 888 529-7222.  Vaginal mesh and bladder slings attorneys are aggressively investigating and litigating cases on behalf of women throughout the United States who have suffered severe complications as a result of the Gynecare (Ethicon) Prolift Anterior, Posterior, and Total Pelvic Floor Repair Systems, Bard Avaulta Pelvic Floor Repair Systems, Boston Scientific Uphold and Pinnacle Pelvic Floor Repair Kits, American Medical Systems (AMS) Apogee, Perigee and Elevate Prolapse Repair Systems and related mesh products. At the same time doctors are offering mixed reactions to women with severe mesh complications.

Below is an article of interest about the vaginal mesh with one of the most open minded medical reviews I have seen. However, discussion of the horror stories  with the  MSW  reveals the complications are very severe and life altering.

with Jane Harrison-Hohner, RN, RNP and Laura Corio, MD

Monday, August 1, 2011

Vaginal Mesh: New FDA Warnings

As a healthcare provider one really knows that a serious concern has arisen when it makes the evening news. But in my book, nothing tops the alarm bells that go off when a medical product suddenly appears on the TV screen at my gym followed by the phone number of an out of state legal firm soliciting for clients. This just happened when I was on the cross trainer last week so it seemed important to share the most accurate information I could find about the newest FDA warnings for vaginal mesh.


You may have had some type of surgical mesh used for, say, a hernia repair. This use goes back to the 1950s. In the 1970s GYN surgeons began using the mesh designed for hernia repairs to help reinforce tissues in the vagina to repair pelvic organ prolapse (POP). Up to 50% of women may experience some type of prolapse (Maher, 2010), but only a few percent will need surgical treatment. In POP, either the bladder collapses down from the upper wall of the vagina (cystocele), the rectum pushes through the lower wall of the vagina (rectocele), or the top of the vagina collapses down the vaginal canal. Yet it was not until 2002 that there was an FDA approved product designed specifically for repairs of pelvic organ prolapse.


Mesh can also be used to elevate the neck of the bladder to treat urinary stress incontinence (SI). Stress incontinence presents with loss of urine with coughing/sneezing/jumping and may be present in 24% of women (Minassian, 2008). Surgeons began using mesh to treat stress incontinence in the 1990s. The FDA approved a mesh specifically for SI use in 1996.

What is the vaginal mesh and what are the problems?

There are four types of surgical mesh: non-absorbable polyester or polypropylene, absorbable synthetics, animal tissues, and combinations of the above. Most GYN and female urology surgeries use the polyester or polypropylene type of mesh

Once a drug or device is approved for use, the FDA has a variety of ways in which problems with a product can be reported. For example, you may have noticed the MedWatch option on some WebMD pages, which allows consumers to report suspected problems. Unfortunately, some women (and their doctors) may not connect a new gynecological problem to a past surgery. One member of our staff shared the following personal experience.


I had this repair done about 10 or so years ago for rectocele. The approach was vaginal and surgical mesh was used. It seemed to be perfect initially, however, as time has gone on, I have had pain issues. I get paroxysmal cramping pain along the wall of the vagina where the repair was made. It lasts from 5-20 minutes, and is bad enough to wake me from a sound sleep. These episodes have increased over time.


I have mentioned it to two doctors and one blew it off, and the other looked puzzled and had no ideas to offer. I have not mentioned it to my newest doctor because it seemed pointless — until I saw the FDA article.


Manufacturers are required to keep track of possible adverse outcomes linked to their products. In the first few years there were 1105 reports of possible problems with mesh used for prolapse repair, or for urinary stress incontinence surgery. In the last three years there have been an additional 2874 adverse reports (FDA, 2011).


According to a just-published FDA report (2011), the most common problems reported when mesh was used for repair of prolapse were:

Erosion or protrusion of the mesh from the soft tissues

Pain, including pain with intercourse

Infections in the area of the mesh

Urinary tract problems

Bleeding from the mesh site

Damage to nearby organs

Who is most likely to have problems with mesh repairs for POP?

According to one of the largest analyses of almost 12,000 women, about 10% of women experienced mesh erosion within a year after surgery. This figure includes both synthetic mesh and biologic types (Abed, 2011). Individual studies have found rates that were as low as 1.2 %, as in a group of 446 women derived from a private uro-gynecology clinic (Stephanian, 2008).

Some risk factors have been described which might predispose a woman to have mesh erode into vaginal tissues. Among 322 women who had a 24 month follow up after mesh repair for POP, having a hysterectomy at the time of POP surgery, and being a smoker increased risk for mesh problems (Cundiff, 2008). When the mesh was placed through a vaginal approach (as opposed to an abdominal incision) there were more mesh complications (Visco, 2001). Other risks may include: increasing age, low estrogen levels, size of mesh implant, and variations in surgical technique (Mistrangelo, 2007). Keeping one’s uterus and use of a mesh just for rectocele repair seemed to decrease risk (Caquant, 2008).


How long does it take for the problems to be apparent?

Mesh problems tend to develop at least a month after surgery for POP (Caquant, 2008) as opposed to the immediate recovery period. The average time for an erosion of mesh to occur may vary by surgery. For those with an abdominal incision for POP, it took 15.6 months versus 4.1 months with a vaginal incision placement, for mesh erosion to be a problem.


Is there a cure?

If a woman has developed pain, or infection, or mesh erosion after a POP surgery, the usual treatment is excision of the mesh via vaginal incision. Thirteen such women were referred to a uro-gynecology clinic for mesh removal. It took an average of two surgeries per patient to remove mesh, and repair any resultant prolapse (Margulies, 2008).

What about mesh used for urinary stress incontinence (SI) repair?

While some 33% of POP surgeries involve mesh placement, over 80% of SI surgeries utilize mesh placed through a vaginal incision (FDA, 2011). Often mesh is used as a sling to elevate and support the urethra. Currently the FDA is reviewing the scientific data on the use of mesh for urinary stress incontinence repair for a later report to the public.

What are the problems reported after vaginal sling surgery for SI?

As discussed earlier, there are several types of materials that can be used for surgical repairs. One of the older synthetic meshes used to make a sling (Mersilene®) had a reported erosion rate of 8% requiring surgical removal. While this material has had decreased use in the past 15 years, some of the women with erosion were 20 years out from their SI surgery (Wohlrab, 2009)

In one group of 179 women with complications from synthetic mesh materials, 125 had a sling placed under the urethra for repair for SI. The most frequent problems were bladder outlet obstruction, pain, and narrow mesh/tape exposure. The mesh complications for SI surgery were found to be different than those for POP repair (Skala, 2011).

A thorough search of published reports of sling surgery complications yielded over 1200 articles. Some complications were more related to surgery (e.g., perforation, bleeding) while others would appear later (e.g., urge incontinence, urinary tract infections, and voiding problems). The number of complications also varied with the type of surgery (Daneshgari, 2008). Not all surgeries utilized synthetic mesh; however for the years examined (1995-2007) mesh was an increasingly popular choice.


How are SI mesh problems treated?

There can be several options for treatment. In one study of 21 patients where vaginal erosion occurred, all were treated with a re-sewing of the vaginal tissues. For 18 women this included surgery for mesh removal. When there was only a small area of erosion, three women were treated with topical estrogen vaginal cream after the stitching. Only two patients needed a second surgery to resolve the problem (Kuhn, 2009)

In the event of vaginal erosion of sling material, the sling should be removed. If only a small area is involved, only the exposed mesh need be removed. The area is then re-sewn (Delorme, 2010)

Unfortunately, if the sling is excised, symptoms can return. Following the removal of a mesh sling, some 36% of women developed new symptoms of urinary stress incontinence (Tijdink, 2011).

On September 8-9, 2011 the FDA will be meeting to review the studies evaluating safety and effectives of mesh placed through vaginal incisions. Repair of both POP and SI will be discussed. Until such time as new guidelines might be published, the FDA asks that women (and their doctors) report suspected problems with GYN mesh use to Med Watch.


Additionally the FDA recommends the following to women who are planning, or have had, mesh surgery for prolapse (FDA, 2011):

Before surgery:

Be aware of risks associated with POP repair using a vaginal incision

Understand that a surgery with mesh might require additional surgery to correct mesh problems–and that in a few cases even repeat surgery may not cure the problem.

Ask your doctor about other POP treatment options. If they recommend mesh, have a clear understanding of why this is the preferred option.


After surgery:


Continue with routine check ups

Notify their doctors if they begin to have persisting vaginal bleeding/discharge, pelvic or groin pain, or pain with sex

…. However most doctors are not recognizing the problems are real,  especially  the ones that put the mesh in according to the helpline…..

Let your doctor know you have mesh. This is especially important if you are planning to have another abdominal/pelvic surgery.

If you are unsure if mesh was used , ask your surgeon if you had a mesh placed during your POP repair. If you have a mesh and need help call the Vaginal Mesh Helpline 1 888 529-7222

Vaginal Mesh News. Urinary Incontinence, Bladder sling Alternative

For women with Urinary incontinence we found this alternative to the vaginal mesh and also the Bladder Sling. As you know Vaginal mesh has been the focus of many lawsuits and controversies. J&J just pulled four Gynacare products off the market and changed the label for the fifth just recently : See article below on a new method to help:

BACKGROUND: Stress urinary incontinence (SUI) is the most common type of urinary incontinence, affecting 15 million women in the United States alone. SUI is the involuntary leakage of urine which occurs during periods of increased intra-abdominal pressure (“stress”).

CAUSE: The primary cause of SUI is inadequate support of the bladder resulting in leaks during activity. SUI affects women of all ages, including approximately 25% of women age 30-59 years, particularly those who have delivered at least one baby vaginally

Other factors that may worsen stress urinary incontinence include: urinary tract infection, obesity, smoking, diabetes, excessive consumption of alcohol or caffeine, and sports like running or tennis. (Source: Mayo Clinic

COMMON SYMPTOMS: If you have SUI, you may experience urinary leakage when you: cough, sneeze, laugh, stand up, lift something heavy or exercise.(Source: Mayo Clinic)


Injectable bulking agents: Collagen, synthetic sugars or gels may be injected into tissues around the upper portion of the urethra. These materials increase pressure on the urethra, improving the closing ability of the sphincter. Because this intervention is relatively noninvasive and inexpensive, it may be an appropriate treatment alternative to try before other surgical options.

Open retropubic colposuspension: This procedure is often used to treat women with stress incontinence. Sutures attached either to ligaments or to bone lift and support tissues near the bladder neck and upper portion of the urethra.

Sling procedure: In this procedure most often performed in women, the surgeon uses the person’s own tissue or a synthetic material to create a “sling” that supports the urethra. Slings for men are used less frequently, but this surgical approach is under investigation. A recently developed technique using a mesh sling has proved effective in easing symptoms of stress incontinence in men. (Source: Mayo Clinic)

RENESSA: Renessa is a non-surgical treatment for women who experience SUI. The Renessa treatment uses a small device which your physician passes through your urethra. It involves the controlled heating of microscopic tissue sites at the base of your bladder, after which the device is immediately removed.

There are no catheters, bandages or dressings to change. It takes about 45 minutes. The full effect of treatment is typically seen within 60-90 days.

Injury Doctors Network , Chiropractor Referral Service

Do to overwhelming deman and requests Injury Doctors Network has launched a Chiropractor Referral Service specifically for the Chiro. In Florida the Georgia the industry has recently become a glut of chiro accident, lawyer referral services. Good ethical chirsos are finding that they are loosing market share to these mass marketers that sway the vulnerable. Chirpractor, chiropractic Referral Service is only ionterested in chiros who have treatment in mind. They mist have a history of  the highest standards in patient care and be able to work with lawyers.

In Florida the $10,000 PIP has lured in some doilar oriented, not medically oriented business people pushing the chiropractor clinic model. This is not what Chirpractor referral Service is all about.

What is a Chiropractor ?

When auto accidents, falls, quick movements, tension, over doing it at the gym, over-exertion or other mishaps occur, the inability of the spine to adjust can result in minor displacements or movement  of one or more vertebrae, causing irritation to spinal nerve roots directly by pressure or indirectly through reflexes, and requiring help from a chiropractor.

Chiropractors are trained, licensed doctors (DC, Doctors of Chiropractic } who use a variety of non-surgical treatments, such as spinal manipulation, mobilization, range of motion,massage, and other techniques  to treat patients with:

  •     Lower back pain
  •     whiplash
  •     auto impact injuries
  •     Neck pain
  •     Repetitive motion  strains
  •     accidents and injuries
  •     Headaches
  •     Sports injuries
  •     work related injuries

By helping the spine to function properly, this allows the nerve interference at that level to dissipate so that the message from the brain can get to that part of the body thus, relieving the pain and discomfort. This may take numerous treatments depending on the extent of the injury.

Ciropractor Referral Service can locate a chirpractor for you. Accepting applications from Chiropractors in:

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Urogynecologists needed to help Women For Vaginal mesh Removal

Vaginal Mesh Helpline, in conjunction with Injury Doctors  Network is seeking Urogynecologists nationwide who can help women with complications of the vaginal mesh Devices. We get calls daily from women with severe complications who do not know where to seek help. and need Urogynecologocal Specialistts who they are able to consult with  regarding the removal of their vaginal mesh implants. if you are a Urogynecologist with experience in Mesh removal please contact the Vaginal Mesh Helpline, or call 1 877 522-2123 If you are an experienced Urogynecologist we need you