Dr. Ostergard on Degradation, infection and heat effects on polypropylene mesh

Nov 2nd, 2011 | By | Category: Medical News

Degraded single polypropylene fiber 1000x

Donald R. Ostergard, MD,  has had a long distinguished career in urogynecology and reconstructive pelvic surgery. Retired from the field, earlier this year he published an article:

Degradation, infection and heat effects on polypropylene mesh for pelvic implantation: what was known and when it was known 

Dr. Ostergard is the sort of doctor that others claim they trained with as part of the bragging rights. Here is his contact information at the University of Louisville School of Medicine. Dr. Ostergard is also the past president of the American Urogynecologic Society.

 

Dr. Donald Ostergard

Surgical Mesh Properties Were Known When it Was Approved

Dr. Ostergard writes that many of the properties of surgical mesh were not taken into account before the marketing of mesh kits. This information was available to the Food and Drug Administration and the mesh kit manufacturers. He writes that the first polypropylene mesh kit cleared by the FDA was used in the transvaginal tape or TVT procedure to treat stress urinary incontinence.

The kit clearance was granted in 1998. Two years earlier in 1996, a woven polyester mesh kit obtained FDA approval.

Dr. Ostergard provides citations for what was known about kits implanted in women until 2003 at which time many new kits were cleared.

The information had been accumulating since the 1950s he says, and provides the documentation that was available for years and includes some of the following and more:

  • An implanted device should not incite an inflammatory or foreign body response
  • An implanted device should be chemically inert
  • An implanted device should not encourage an allergic reaction
  • An implanted device should stand up to mechanical stress
  • An implanted device should not be modified by tissue fluids
  • An implanted multifilament suture attracts bacteria 5-8 times greater rate than a monofilament suture
  • Pore size is important for tissues to incorporate with the mesh
  • As soon as mesh is implanted bacteria and host defense cells race to the mesh surface
  • Bacteria migrate alongside the synthetic fibers
  • Polypropylene mesh shrinks 30-50% after four weeks
  • Bacterial colonization was found in 33% of mesh that had been removed
  • The abdominal wall stiffens after mesh is implanted
  • Mesh surface predicts bacterial adherence – multifilament mesh has a 205% increase in surface area which may explain infections up to years after it’s implanted
  • Degradation occurs in all meshes.

The article which is available here. in the International International Urogynecology Journal, Volume 22, Number 7,   Published April 2011, Open Access at Springerlink.com

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20 Comments to “Dr. Ostergard on Degradation, infection and heat effects on polypropylene mesh”

  1. Liz Reece says:

    Thank you for bringing this horrifying information into the public domain, Jane, and deepest thanks to Dr Ostergard for all his work. I have read other research of his, always gratefully.

    When, when is this sort of information going to be seen in the right circles such that doctors STOP using mesh? It is beyond belief that so much published research is so pro mesh… It doesn’t add up when we know of so many harmed people and hear of the misery they are trying to get help with. The research by Dr Ostergard suggests that there is a disaster waiting to happen as lots of women and men treated with mesh find that it has deteriorated or infections have surfaced over time.

    • Jane Akre says:

      He reminds me of so many others who were/are the lone voice. It reminds us all to listen to those lone voices… they may have something to say.

      • jade says:

        Jane – I haven’t heard much about the “settlement talks” underway for 5 of the manufacturers. Can you update this information? Would it be a “spot-on” assumption to say we’ll never see another bellweather trial and that, most likely these cases will be settled by the end of this year? This research and information from Dr. Ostergard, alone, is so damaging to the defense. What are your thoughts on this? Thanks…

      • jade says:

        Hi, Jane – Unless I am misunderstanding the new position of AUG issued today – I am disturbed about AUG’s endorsement of vaginal mesh implants for any POP. The FDA did not differenciate in their warning of July 2011 to say that “complications were NOT RARE”.
        “The FDA is issuing this update to inform you that serious complications associated with surgical mesh for transvaginal repair of POP are not rare. This is a change from what the FDA previously reported on Oct. 20, 2008. Furthermore, it is not clear that transvaginal POP repair with mesh is more effective than traditional non-mesh repair in all patients with POP and it may expose patients to greater risk. This Safety Communication provides updated recommendations for health care providers and patients and updates the FDA’s activities involving surgical mesh for the transvaginal repair of POP.”
        If I am reading this correctly, AUG has, AGAIN, misled and betrayed women in this newly issued statement. This alone shows that AUG is NOT interested in the safety and the lives of women (so many suffering, losing their partners, losing their children and losing their life) destroyed by polypropylene and this procedure. I guess AUG cannot say “we were wrong – we apologize – how can we help all of you who have been injured and misled? This is their response to our suffering???? Just like the doctors who denied us our dignity by telling us we were “unique”, “too active”, “imagining our pain”, “needed counseling”, “needed PT” and the list goes on! AUG abandoned us THEN, and now AGAIN, as will their doctors. BTW: Those doctors who think that Urogynecoloy is a “board certification” – it WAS NOT back in 2009 – there was NO SUCH thing – we ALL were fooled then and they continue this coverup. For all of those who believe this position from AUG is not motivated by economic gain and not another slap in the face of women – I have a piece of swamp land in FL I’d like to sell you!

        • Jane Akre says:

          Its the media’s fault and lawyers too… What does that say about women?

          • jade says:

            It does not speak good of either the media, nor the lawyers. But, Women are “The Rose” – the Vessel from which all life springs; the Nuturer; the Forgiver and the Haven. Every person who denies this must answer to his own “God” sooner or later. Being born a women is both a curse and a blessing.

      • jade says:

        Hi, Jane – I would be curious to know Dr. Ostergard’s take on AUG’s latest position statement regarding TVT. He must have an abundant number of fellow AUG doctors who do not agree with this recent position as I am certain he does not. Since Dr. Ostergard was past president of AUG, I believe he must be disturbed by this statement enough to counter it.

  2. […] Dr. Ostegard’s research he shows how the mesh becomes encapsulated with bacteria when inserted vaginally. (see full […]

  3. i appreciate someone telling the damn truth, i am about dead from this mess, from what my dr says i do not have much longer to be here ,i am in so much pain ,it doesn’t matter anymore.Ican’t take anymore , thanks for telling the truth.

  4. […] Degradation, infection and heat effects on polypropylene mesh […]

  5. […] Degradation, infection and heat effects on polypropylene mesh […]

  6. Julie says:

    Thank you so much for bringing this to light. My Mom has suffered terribly since she had her mesh implant and we are desperate to get her help. If anyone could refer us to a doctor who could remove her mesh we would be eternally grateful. We live in the Albany, NY area but I would travel anywhere to get her help.

    • Connie Gayer says:

      Julie Dr. Raz at UCLA, he is the best, i just had mine removed last thursday and i am doing well so far. People go to see him from all over the world.

  7. Mary pat says:

    Dr Una Lee at Virginia mason can remove mesh. She is a urologist. She trained under dr Raz. She worked with Dr raz at UCLA. She is kind and smart. She will b easier to get apt with than Dr Raz.

  8. Mary pat says:

    Virginia Mason is in Seattle Wa.

  9. linda wilson says:

    Please help me…. I have been to doctor after doctor, and can not get any real info from them. Back in 2007 10/13 ) I had surgery to repair: ( 1 ) I had a stage 2- Bp / Ba vaginal vault prolapse. ( 2 ) Stress urinary incontinence ( 3 ) Overactive bladder ( 4 ) Cervical polyp. I had a operation that was suppose and do ( 1 ) Total Prolift procedure to correction of cystocele, rectocele, and enterocele. ( 2 ) Vaginal colpopexy using the Prolift kit. ( 3 ) Extensive perineoplasty. ( 4 ) Advantage mid-urethral sling with water cystoscopy. ( 5 ) Cerical polypectomy. ( as listed on the operative report ) Over the years I have had so much pain in my lower stomach, along with nerve pain. Had to have nerve surgery on my back a few months ago. The mesh does not show up on a contrast C.T. I am peeing out allot of white crap and I put in in a jar of my urine and it all floats to the bottom. And it will join together like a cloud. Also this past Feb. 2013 I have now a prolapse with my womb down in my vagina. And along with all of the pain, I have had so many U.T.I. infections, from having a Cather, to Cauterizing my self at home. I can not get a straight answer to this stuff coming out of me. ( It has not been tested ) Also my urine has a oil looking film on top of it. Please, please help me with this. The mesh kit was from the company Johnson & Johnson, which was pull off the market. Thank you, Linda

  10. Connie Gayer says:

    Linda i have just went to California to have mine removed. I went to see Doc Raz at UCLA. He and his staff are the best to go see. I just came home on Christmas eve and i am doing great. I have not let anyone else cut on me so my recovery has been good so far. The pain has not been bad for me. I will be going back in a few months and having reconstruction done and my prolapsed fixed. Mine had started to grow to my leg bone and my pelvic bone. If you have to go to anyone go there they are like i said, the best. Dr. Raz knows what he is doing. I am from Arkansas and wasn’t really sure how i was going to make this work but things fell into place. I hope you can get some relief because i know what you are going through.

  11. teri says:

    UCH LONDON ENGLAND. MISS S. ELNEIL surgeon urologist . private PORTLAND ST. LONDON.ENGLAND gentle sympathetic. knows exactly problems relating to mesh implants from personal experience she is to me the best. I cant thank her enough for what she has done for me.I was suffering excruciating pain,etc,etc, She gave me back a quality of life, I thought had gone forever.

    • max says:

      DITTO. Anyone who is willing to travel to London, Miss Sohier Elneil is the best and I believe does around 3 mesh removals per week nowadays. WONDERFUL FIRST CLASS SURGEON.

  12. Sharon Bearden says:

    What about those of us who have no money to travel to get any help? I’ve been told by several mine has spider webbed and if removed I wuld have a coostomy bag and a urineostomy bag. What do we do?????

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