What a “Mesh” by Dr N

Dear Readers,
There are commercials out there that warn patients about Mesh. This has become a new four letter word in medicine. I am saddened that advertisements can have a deleterious effect on patients’ well being. If I am watching television for enjoyment and I see an ad that frightens me about my own medical condition, this is wrong. If it makes patients feel fear or doubt, the commercial is doing harm. This should not be allowed. Yes, there have been some poor outcomes in some patients with some devices. That can be said about most surgical devices. Not everyone has the outcome they desire and at times there are complications. It is a complicated decision making process that leads a physician to choose a certain line of therapy and surgical intervention. Physicians are trained to ‘do no harm’ and make the best decisions they can make for a given patient.
The MESH problem arose because it was used in the vagina to correct complicated prolapse patients and a higher than expected amount of erosion, in the vagina occurred with some devices. I never used the devices that were recalled. Erosion at times, led some patients that have pain or problems with intercourse. I do not want to minimize the problems that have arisen. Some of the products have been removed from the market to allow further study in this area. That does not mean that ALL MESH is bad in ALL areas of the body and should never be used. Patients are now afraid of the word and if used by board certified, good providers and surgeons- patients will often say NO I don’t want that before they even listen to what is being recommended and why. Informed consent is very important but the harm that this form of advertising is wrong and places and undue amount of fear and anxiety where it is not needed. It belongs in the consultation between the physician and the patient. It belongs in informative publications that are based on fact not advertising. It needs to be part of an informed consultation where all the facts are presented or even during a second opinion, which I encourage. There is mesh used in blood vessels, under the bladder, to support the abdominal wall, in neurosurgery and other specialities and it helps a lot of people, a lot of the time. Complications happen. But lets give and get good information in a compassionate, understandable format. Not television commercials. And for that matter, I think medical information on the internet needs to be regulated so people do not get hurt. That is another topic. But yes, it’s a MESH and I hope patients will not let commercials affect their peace of mind. Talk to your doctor and get good evidence based information. Please do not let fear guide you. Dr N

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