Pudendal neuralgia may improve after vaginal mesh implant removal. Pain that persists more than six months may need further evaluation and possibly neurolysis. “
Don’t Wait In Vain For Pelvic Pain To Resolve After Removal of Mesh Implants
Women suspected of having pudendal neuralgia following transvaginal mesh implant surgery more often than not require complete removal of the mesh. Following mesh implant removal it is prudent to wait six months to determine if symptoms resolve or persist. If symptoms of pudendal neuralgia persist further diagnostic testing and therapeutic injections will be necessary, and potentially intraoperative neurolysis, a procedure that removes scar tissue away from the nerve, may be necessary.
Unfortunately there are few centers with the capabilities to remove vaginal mesh implants and provide comprehensive care for nerve related pelvic pain. The necessary skills include CT guided diagnostic blocks and intraoperative neurolysis.
It is important for women to understand peripheral nerve repair by way of neurolysis and nerve grafting have been done for years in the neurosurgical and plastic surgery fields. Only recently have urogynecologist begun dealing with this complex problem and there are only a small few with the necessary training to deal with nerve compression. Peripheral nerve regeneration following decompression of the nerve, which may occur with simple removal of the mesh, occurs at a pace of one centimeter a week. Six months provides the necessary time to allow for full regeneration and reinnervation following vaginal mesh implant removal. If pain persists there are urogynecologists with the necessary skills to deal with the persistent pain from nerve damage by way of intraoperative neurolysis.
There are treatments for pelvic pain that persists following the removal of mesh implants and the journey to a more functional life does not stop with complete removal of vaginal mesh implants or a vaginal mesh lawsuit. Undue delay in seeking treatment for pain from ongoing compression from scar tissue and traction injuries likely leads to further permanent disability.
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