AUGS - Patient Presence Missing from Urogyn Society Meeting

Colorado Convention Center Blue Bear

Mesh Medical Device News Desk, October 3, 2016 ~ With an emphasis on innovation and advancement in the practice of urogynecology, at the AUGS annual conference of specialists, there were few reminders about the outcomes of, what's been described as the darkest chapter in women's health history, that is, the patient presence.

The iconic giant blue bear peering into the Denver Colorado Convention Center was the most photographed image from day one of the annual American Urogynecologic Society (AUGS) Pelvic Floors Disorders Week. (Tweet #PFDWeek)

Tweets were aflutter from the 1,300 in attendance, whether urologists, gynecologists, fellows, surgeons or urogynecologists, a relatively new field combining female pelvic medicine and reconstructive surgery with gynecology to treat pelvic floor disorders in women.

Geologists convention also in the CCC

This was the 37th time the society had met to listen, share and learn. Residents, doctors in training, were there to grab a fellowship in this specialty, and young, attractive women in stilettos and young men in neat, new suits, were being interviewed in the lounge areas with hopes of joining the lucrative field of corporate sales or marketing.

Also in attendance were the key opinion leaders (KOL) of AUGS. These are some of the most experienced doctors in this subspecialty, according to the society, and those who shape the face of AUGS. Industry-sponsored education was led by the KOLs who trained other doctors, hoping to bring more into the corporate tent of the largest medical device makers.

Monday night. Colorado Convention Center

Here is the final program.

Monday night the exhibit hall was yet to be set up, but boxes from major medical device manufacturers were waiting to go on display.

CORPORATE SPONSORS

Coloplast room key, Hyatt Regency

At least half of the expenses of this convention were covered by industry, according to AUGS leadership.

Sponsorship at the Platinum Level of $75,000 included Allergan, Boston Scientific, Coloplast and Medtronic, Inc.

That premium price would buy you a booth or two in the exhibit hall, premium placement of your company logo and banners.

Available for a price were glossy brochures left on tables in the exhibit hall where you'd eat your industry-supplied lunch, a draped back wall, a coffee cart, water bottles, an aisle sign and charging station. The Wi-Fi access was provided courtesy of Allergan, which was the login password.

Your sponsorship included a logo labeled hotel key card at the nearby Hyatt Regency.

Here are the PFDWeek costs. See the AUGS Exhibitor and Sponsor Guide, and an example of a ceiling banner from Boston Scientific.

Dr. Peter Rosenblatt for BSC

Gold level sponsors paid $50,000 and included Astellas, while the Bronze level sponsors at $10,000 were Caldera Medical, Cogentix Medical, CooperSurgical, Neomedic International and The Prometheus Group.

The $5,000 Copper Level sponsors included Pelvalon, Syneron Caldela and Universal Triumph.

Exhibit floor, CCC

KEY OPINION LEADERS

Not surprisingly, the key opinion leader’s names appear among the top donors to AUGS and include Drs. Andrew Cassidenti and Vincent Lucente.

Drs. Cassidenti and Lucente, Donors of the Year

The generosity is reciprocal - Cassidenti lists Boston Scientific, Consultant; Coloplast, Consultant; as well as a Defense expert witness vaginal mesh litigation.

Dr. Lucente lists Allergan, Speaker and Grant/Research Support; American Medical Systems, Consultant; Coloplast, Consultant; and Medtronic, Consultant. At trial, he's cited as the $1.7 million consultant for Ethicon.

Ethicon table

Ethicon, a division of Johnson & Johnson has the most defective product lawsuits filed in the U.S., in excess of 45,000, yet its presence here was minimal.

The company has taken off the market its larger TVM (transvaginal mesh) kits for pelvic organ prolapse.

Also missing was the presence of any patient advocates or patients to engage and share with those present. Note* as editor of a website read by many mesh injured, I intentionally kept a low profile, sensing my presence would not be welcome. That theory was later proven true.

Even the few doctors I spoke with, who treat mesh-injured, kept their sentiments to themselves, acknowledging they were in the vast minority.

AUGS generated $5 million in revenue in 2015 and has plans for a new building in Silver Springs, Maryland, and has since 2007 seen an incremental expansion of membership and revenue, up 30% and 38% respectively.

AUGS Panel discussion

TOPICS

Discussions to be had during the four-day event included a return to native tissue repairs; evaluating common female urological concerns; bladder injuries; advances in laparoscopy and robotic reconstructive pelvic surgery; coding and ultrasound; as well as the coming changes with federal Medicare reimbursement for physicians known as MACRA.

The Best Paper Award went to Dr. Pamela Moalli, MD of the University of Pittsburgh for Regeneration of Vaginal Support Utilizing an ECM Bioscaffold, a discussion of alternatives to polypropylene to support a vaginal floor prolapse. The patented MatriStem ECM by ACell is an extracellular matrix product to repair damaged tissues.

Science of mesh products is ever evolving. Expect robotics to grow and alternatives to polypropylene for implants. Doctors are returning to sacrocolpopexy and native tissue repairs.

An estimated 3.5 million mesh slings have been implanted and approximately one million transvaginal mesh kits. The litigation that's has emerged as mesh-injuries evolved mean that next to asbestos, this is now the leading mass tort ever filed in this country.

Women report constant and chronic pain and infection, mesh erosion, mesh shrinkage, scar formation, pudendal nerve damage, and autoimmune responses to mesh, among other post-surgical outcomes. One wouldn't know that because these minimally-invasive procedures have had minimal media coverage.

With all the emphasis on innovation, one could only wonder what influence mesh litigation has had on these doctors individually and the society as a whole.

Woman in stirrups in demo booth

With more than 100,000 lawsuits filed in the U.S. alone alleging polypropylene mesh is a defective product, what was the current thinking among AUGS members and leadership?

Were the corporate mesh makers - Boston Scientific, Ethicon/ Johnson & Johnson, Caldera Medical, Coloplast among them, still able to cultivate relationships with doctors despite the fact that of the 20 trials conducted so far, the defense had won just six.

Of the 14 mesh-injured women who proved their case at trial, all were awarded compensatory damages and in some cases punitive damages intended to punish a company.

Jurors made those decisions, presumably after listening to evidence from both sides.

What did the doctors here know about that and how would the society address those women with life-altering mesh complications?

I assumed most physicians are intelligent, thoughtful people who entered medicine to help others.

I was there with opened eyes and ears to take the temperate of the society as a whole and to learn what was on the horizon for the treatment of stress urinary incontinence (SUI) and pelvic organ prolapse (POP), considering all that has recently transpired and continues to evolve. ###

STILL AHEAD: The Great Mesh Debate that was cancelled. A word from the AUGS President.

MORE IMAGES FROM AUGS

Colorado Convention Center and Blue Bear

Caldera Medical brochure