Dr. Greg Vigna discusses the unique risks associated with the arms of polypropylene retropubic and transobturator slings.

“Extrapelvic pain caused by the arms of retropubic and transobturator slings are responsible for pudendal, obturator, and/or ilioinguinal neuralgia. Some women with transobturator arms report neuropathic pain and weakness involving the ankle and foot as part of the clinical diagnosis of CRPS. It is abundantly clear that polypropylene slings were and continue to be a very bad idea”… Greg Vigna, MD, JD

Greg Vigna, MD, JD, practicing physician, national pharmaceutical injury attorney, and Certified Life Care Planner states, “The 2020 American Urogynecological Society and the International Urogynecological Association Joint Position Statement on the Management of Mesh-Related Complications for the FPMRS Specialist describes the unique risks the arms of polypropylene retropubic and transobturator slings as they are known to cause extrapelvic pain related to neuralgia from impacted nerves. Unfortunately, the literature that supports the association between midurethral sling and pudendal, obturator, and ilioinguinal neuralgia largely unread by physicians and injuries are ongoing.”

“Considering all factors including treatment options, invasiveness of treatment, resulting disability, I don’t see much worse than extrapelvic pain caused by the arms of polypropylene devices.” – Dr. Greg Vigna

Dr. Vigna says, “We have been well aware of the literature that was cited by the Joint Position Statement that supports obturator, pudendal, and ilioinguinal neuralgia as it has been around since 2010. Over the past couple of years, there has been additional important medical literature that supports injuries from transobturator arms that become symptomatic months to years after implant and a retrospective study of women who suffered from pelvic myofascial pain or spastic pelvic floor that proves that myofascial pain is caused by polypropylene mid-urethral slings.”

Dr. Vigna adds, “Properly positioned mid-urethral slings are causing horrible pain syndromes involving muscles and nerves. The extrapelvic pain from the arms of polypropylene devices produce severe pain syndromes in the groin and pelvis that basically destroys a life for the treatment of incontinence. Polypropylene devices are not necessary for the elective surgical management of stress urinary incontinence as there are clearly safer options and the literature supports this position.”

Dr. Vigna concludes, “As a Physical Medicine and Rehabilitation physician practicing hospital medicine I have cared for hundreds of patients with spinal cord injury deafferentation pain, amputees with phantom pain, and RSD following crush injuries. Considering all factors including treatment options, invasiveness of treatment options, resulting disability, and quality of life I don’t see much worse than extrapelvic pain involving the groin and pelvis caused by the arms of polypropylene devices. The neuropathic pain and weakness at the foot and ankle add another layer of complexity in the management of the extrapelvic pain from midurethral slings as this appears to be part of a complex regional pain syndrome that few doctors have the capability to treat and reliably diagnose with selective nerve and muscle blocks.”

Dr. Vigna is a California and Washington D.C. lawyer who focuses on catastrophic neurological injuries caused by transvaginal mesh devices including pudendal neuralgia, obturator neuralgia, ilioinguinal neuralgia, and Complex Regional Pain Syndrome. His cases are filed around the country with Martin Baughman, a Dallas Texas firm. Ben Martin and Laura Baughman are national pharmaceutical injury trial attorneys in Dallas, Texas who specialize in ‘one off’ catastrophic injuries caused by the IVF filter and vaginal mesh.

Learn more on the anatomical basis for TOT injury or irritation to the obturator and pudendal nerve and the treatments of obturator and pudendal neuralgia: https://vignalawgroup.com/ebooks/pelvic-mesh-pain/#page=59

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For articles, video resources, and information visit the Pudendal Neuralgia Educational Portal or https://tvm.lifecare123.com/.
Read on for information regarding sling related complications: https://tvm.lifecare123.com/slingebook.html

Greg Vigna, MD, JD
Vigna Law Group
1155 Coast Village Rd., Suite 3, Santa Barbara, CA
1-800-761-9206

References:
https://www.augs.org/assets/1/6/Joint_Position_Statement_on_the_Management_of.99428.pdf

Greg Vigna, M.D., J.D., Certified Life Care Planner
Academic Physician Life Care Planning
+1 800-761-9206
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