Harvard Pilgrim Health Care does not recognize pudendal nerve decompression as a covered procedure ‘because treatment effectiveness has not been established.’

Harvard Medical School is recognized as the leading destination for brachial plexus reconstructive surgery in North America providing nerve transfer procedures and nerve grafting to restore non-functional extremities to functional. Despite Harvard’s Medical School’s recognition of the value of nerve decompression, nerve grafting, and nerve transfers Harvard Pilgrim Health Care does not recognize pudendal nerve decompression as a covered procedure ‘because treatment effectiveness has not been established.’ This is clear evidence that barriers to needed medical care is ongoing to the injured women of the vaginal mesh debacle.

Pudendal neuralgia have been a well described complication of transvaginal mesh (TVM) devices used in the treatment of stress urinary incontinence. Transobturator slings include the Johnson and Johnson TVT-O, Coloplast Aris, American Medical System Monarc, and the Boston Scientific Obtryx and all of these devices pierce the obturator internis which makes up a wall of Alcock’s canal were the pudendal nerve runs causing pudendal nerve entrapment by way of spasm and scar tissue.

It is time for insurances across the country… to step up to meet this national crisis caused by the vaginal mesh debacle.” Dr. Greg Vigna

Pudendal neuralgia is well described in the literature and are common complications of the now FDA banned TVM devices previously used for pelvic organ prolapse (POP). These devices include Johnson and Johnson Prolift, Prosima, Gynecare PS and Boston Scientific Uphold to name a few.

Dr. Greg Vigna, practicing physician, national pharmaceutical injury attorney, and pudendal neuralgia expert states, “My clients have benefited from pudendal nerve decompression with findings of compression from scar tissue, pieces of mesh, and sutures. This surgery will not be a cure for this malady but appears to tangibly improve the quality of life of my clients who have suffered complications from transobturator slings and the now banned devices for POP.” He goes on, “I have seen improvement very much the same as I have seen injured children operated for brachial plexus surgeries by leading brachial plexus surgeons. Brachial plexus surgery doesn’t cure the injury but there is a meaningful improvement in quality of life. It is time for insurances across the country like Harvard Pilgrim Health Care, and Managed Care Medicare Plans across the country to step up to meet this national crisis caused by the vaginal mesh debacle. Pudendal nerve decompression is no different than brachial plexus injuries as it relates to outcome and should be a covered procedure.”

For articles, video resources, and information visit the Pudendal Neuralgia Educational Portal (https://pudendalportal.lifecare123.com/) or https://tvm.lifecare123.com/. We also have a new eBook discussing the consequences of sling implantation (https://tvm.lifecare123.com/slingebook.html).