If you are considering treatment options for a fallen bladder, uterus, or vagina, or bothersome stress incontinence, you should gather as much up-to-date information as possible. Transvaginal mesh is often used as a treatment to hold up a fallen bladder or stress urinary incontinence.

The Food and Drug Administration (FDA) issued a Medical Device Safety Alert about reports of complications associated with the placement of mesh through an incision made in the wall of the vagina. The FDA has received more than 1,000 reports from 9 manufacturers.

"The most frequent complications included erosion through the vagina, infection, pain, urinary problems and recurrence of the fallen bladder and/or incontinence.

Erosion and related vaginal scarring has sometimes led to discomfort and pain, including pain during sexual intercourse. Some patients needed additional surgery to remove the mesh. Injuries to adjacent organs, such as the bowel, bladder, and blood vessels was also reported to FDA.

The FDA urges women to discuss with their physician the pros and cons of using mesh for their particular stress incontinence problem. It lists 9 areas that patients should definitely discuss with their surgeon before agreeing to surgery:

1. Tell your surgeon whether you have previously had a reaction to mesh or polypropylene materials.
2. Ask what the pros and cons of using surgical mesh in your case in particular
3. If mesh is to be used, ask your surgeon what's been his or her experience with implanting this particular product--and what has been the experience of other patients that the surgeon has treated.
4. Ask how your surgeon deals with complications that might arise.
5. Ask what changes to expect after the surgery and how long to expect the results to last.
6. Ask about any specific side effects that you should tell your surgeon about after the surgery.
7. Find out what options you have, if for some reason, the mesh doesn't resolve your problem.
8. Find out what follow-up treatment would be done if you have complications related to the mesh--can the mesh be removed and what would the consequences be?
9. If a mesh is to be used, ask if for patient information that comes with the product

Reporting Complications to the FDA

Keep this on file:

You can report any problems to the FDA's MedWatch Adverse Event Reporting program either online, by mail, or fax:

• Complete online MedWatch Voluntary Reporting Form 3500
• Mail: MedWatch Forms to MedWatch, 5600 Fishers Lane, Rockville, MD 20852-9787
• FAX: 1-800-FDA-0178
• Phone: 1-800-FDA-1088

Related Resources

Video on Stress Urinary Incontinence.

Good news: people are starting to chime in on the urology forum. I imagine that there are plenty of readers out there who might have urology concerns on their minds.

Right now, I have broken the forum up into three areas: for women, for men, and for kids. So try to post in the right category. Later there will be more.

We have some good discussions going on:

• urinary incontinence in women
• preventive antibiotics for kids with recurrent urinary tract infections
• some cutting-edge research on the origins of prostate cancer

I'd like to point you to my new articles on an enlarged prostate , which are also in the spotlight now on my home page. I have heard of so many guys feeling frustrated by their symptoms of an enlarged prostate, wondering what treatments are for them, and if the treatments will end up worse than the bother they experience now.

The opportunities to discuss new topics is wide open, given that the messages are appropriate and informative.

You can sign up for my forum and newsletter at the links above. Hope to get to know you.

Sales of Aranesp, the chronic kidney failure and anemia drug, were promoted through a kick-back scheme, alleges a suit against Amgen and AmeriSourceBergen Corporation, filed by 14 states and the District of Columbia. The kick-back scheme allegedly worked by providing free drug samples that were added to vials, The excess drug could then be used to treat patients and billed to Medicaid and other third-party insurers.

Physicians received sham consultant agreements and other services in exchange for promoting the drug to Medicaid and other third-party payers, according to a statement from N.Y.S. Attorney General Andrew Cuomo's office.

Amgen responded in a statement that the suit was "without merit" and is complying with lawmakers.

Once Amgen's product leader, Aranesp lost market share from $4.1 billion in sales in 2006 to $3.1 billion in 2008. The decline appears to be linked to questions about safety in kidney failure patients, particularly heart attacks and strokes. Its safety was questioned again this week in a clinical trial report in the New England Journal of Medicine, which revealed that kidney patients taking Aranesp had twice the rate of stroke as those on placebo.

© Fotolia

Testicular cancer gets a lot of news coverage because of Lance Armstrong and other popular young athletes stricken with the disease. It upsets us when we hear about young men in the prime of their lives afflicted with it, but most of us have no idea how men with the disease do in the long term.

Now, there is good news that testicular cancer survivors report that their quality of life is good overall-- in fact the same as those for similar men without testicular cancer. Using standardized tests, a team of researchers studied all men treated at a Danish hospital between 1990 and 2000. They found testicular cancer survivors reported no statistically significant differences in a broad range of outcomes, including physical functioning, cognitive functioning, emotional functioning, depression, fatigue, motivation, and mental fatigue.

An examination of the impact of treatment strategy on outcome found that among patients treated with radiation therapy, a relatively high proportion reported GI symptoms. Patients who underwent chemotherapy reported higher levels of peripheral sensory neuropathy, hearing problems, and Raynauds syndrome. The authors state these problems are widely known to be irreversible.

If you or someone you know has testicular cancer, share this information with them. It may help them cope with dealing with getting effective treatment.

Sources

Health-related quality of life in long-term survivors of testicular cancer.

Related Links

Testicular cancer. Health Topics A to Z. Downloaded Oct. 29, 2009.