Vaginal Mesh Implants

At present, the vaginal mesh implant scandal has been compared to the thalidomide scandal which plagued women of the 1960s and their infants.

The synthetic polypropylene implants were used as an alternative to more invasive procedures for the treatment of urinary incontinence and prolapse that occurs after childbirth. Many patients began to complain about chronic pain, bladder spasms and continual pelvic pain due to the mesh cutting through vaginal tissue as well as an inability to walk after sex.

The mesh implant launched by Johnson & Johnson without a clinical trial has led to law suits on all fronts and an estimated $57 million dollars was given to one woman alone as compensation.

It was revealed earlier this year that over 800 women will be taking legal action against the NHS for its part in the scandal. Thousands of woman had been advised to have tension-free vaginal tape surgery across the United Kingdom. Over 92,000 women have had these implants from 2007-2015. Despite having the implants being removed, many women will have to deal with permanent side effects both psychological and physical. A campaign known as Sling the Mesh has been launched.

Professor Carl Heneghan from the University of Oxford compared the scandal to the thalidomide scandal as the thalidomide scandal resulted in an immediate change in drug regulation and this scandal will do the same with the regulation of devices and implants.

Many have criticised the medical proffession and doctors of all ranking after the scandal. There was a desperate need to have stricter regulations and a better approach to the complaints made by women post-operatively as this could have resulted in many of them not having to deal with permanant side effects. This scandal has been incredibly eye opening and will hopefully result in stricter regulations worldwide when dealing with implantation of devices.

References:

http://www.bbc.com/news/uk-scotland-27887766

https://www.theguardian.com/society/2017/sep/29/revealed-johnson-johnsons-irresponsible-actions-over-vaginal-mesh-implant

https://www.theguardian.com/society/2017/aug/31/vaginal-pelvic-mesh-explainer

http://www.bbc.com/news/uk-41671020

http://www.bbc.com/news/health-39567240

http://www.independent.co.uk/news/long_reads/transvaginal-mesh-vaginal-procedure-surgery-tvt-gynaecology-thalidomide-womens-health-psychology-a7862126.html

http://www.telegraph.co.uk/health-fitness/body/vaginal-mesh-scandal-could-bigger-thalidomide/

https://www.theguardian.com/society/2017/oct/19/vaginal-mesh-implants-if-i-lift-my-leg-my-whole-body-shakes

https://slingthemesh.wordpress.com/

 

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Trigeminal Neuralgia

The trigeminal nerve or fifth cranial nerve is the nerve that sends pain impulses to the brain. When the nerve malfunctions, impulses can be sent at the wrong time, when there is no real pain. However, the sufferer will still feel sharp pain of great intensity. It usually occurs when the protective coating around the trigeminal nerve, the myelin sheath is damaged. High blood pressure, tumours and multiple sclerosis can cause this damage. Rarely, a tangle of arteries and veins called an arteriovenous malformation can also lead to the attack. The attacks can span from a few seconds or to a few minutes, the pain is often unbearable It often only affects one side of the face, usually the right hand side.

The attacks are often brought about by light touching of the face, this can be due to light intensity, wind, air conditioning, eating, washing and even breathing. This means that it is incredibly difficult to control. It usually occurs in those who are over 40 and is more frequent in women than in men.

Treatment can vary but usually:

  1. Anticonvulsant Drugs

Carbamazepine is often used in treatment in order to prevent nerve firing. It slows down nerve impulses, reducing the ability to transmit pain messages. It has to be taken in large doses in order to be effective.

2.  Surgery

Surgery such as nerve replacement therapy can be used in treatment. Through cutting part of the nerve, numbness occurs and the pain is dulled or ceases. However, the nerve may regrow which results in further pain and the need for more surgery and medications.

The National Institute of Neurological Disorders and Stroke (NINDS) is researching the disease. Mice can be used to understand the relationship between the nervous system and the vascular system. Researchers are looking at the role estrogens may play in affecting nerve pain activity, due to the disease being more prevalent in women compared to men.

 

References:

https://www.tna.org.uk/pages/condition.html

https://www.tna.org.uk/pages/condition.html

https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Trigeminal-Neuralgia-Fact-Sheet#3236_1

Female genital mutilation

Female genital mutilation (FGM) refers to the procedures involving removal of parts of female genitalia. The genitals may be cut, injured or deliberately altered for non-medical reasons. FGM usually takes place when girls are infants until the age of puberty. The practice is banned in the UK.  FGM is globally recognised as a human rights violation, but despite being banned, some people choose to carry the procedure out illegally at home or in a private community.

As it has no medical/health benefits FGM is usually carried out for cultural, religious and social reasons. In some communitites it is seen to prepare a woman for marriage or to preserve her virginity. It must be stressed that there is no justification for these kinds of procedures and as a society we must continue to strive to prevent more women from having to suffer throught such a harmful and dangerous procedure.

There are four main types:

  1. Clitoridectomy – this is a removal of the clitoris and can be partial, sometimes only the skin around the clitoris is removed.
  2. Excision – removal of the clitoris as well as of the labia minora, but not the labia majora, which is a larger flap of skin around the vagina.
  3. Infibulation – implanting a seal over the vaginal opening and narrowing it, this is done by removing pieces of skin from elsewhere and placing them over the vaginal opening using stitches in most cases.
  4. Other – harmful procedures include: pricking, cauterizing and scraping the vaginal area.

 

It is clearly evident that undergoing FGM is traumatic for any woman involved and the effects will be with a woman for the rest of her life., but sometimes women and girls can die from the procedure due to unsanitary conditions and lack of medical guidance when carrying out the mutilation. Some of the side effects include:

  • Severe pain
  • Urinary problems
  • Shock
  • Haemorrhage – severe bleeding
  • Swelling of the genital area
  • Scar tissue malformation
  • Childbirth complications risk increasing
  • Infections
  • Sexual problems, during and after intercourse
  • Psychological problems following the emotional trauma

Treatment:

In some cases, treatment will not help, but in others procedures can be undertaken such as deinfibulation to widen the vaginal opening and to recontruct damaged areas of tissue.

If you know someone who is having an FGM procedure, has had one or if you have had one or will have one yourself it is essential to call the police and to obtain aid. You can see your GP or visit a gynaecologist for additional help.

Police: 999

NSPCC: 0800 028 3550

Childline: 0800 1111

References:

http://forwarduk.org.uk/key-issues/fgm/

http://www.nhs.uk/Conditions/female-genital-mutilation/Pages/Introduction.aspx

http://www.who.int/mediacentre/factsheets/fs241/en/