Transobturator slings were the standard of care for the surgical management of SUI but are now known to cause disabling pain syndromes like pudendal neuralgia.
Transobturator slings once considered as the standard of care for the surgical management of stress urinary incontinence has essentially been banned in England since April 2, 2019 when the National Institute for Health and Care Excellence published their position:
Do not offer a transobturator approach unless there is specific clinical circumstances (for example, previous pelvic procedures) in which the retropubic
approach should be avoided.
The position statement is based on the disabling pain syndromes that are caused by transobturator slings.
“…transobturator slings cause pudendal and obturator neuralgia immediately after placement or, in others, develop symptoms months or years after implantation.” — Dr. Greg Vigna
Dr. Greg Vigna, practicing physician, national pharmaceutical injury attorney, and Certified Life Care Planner comments, “Defense experts can’t seem to say the words pudendal neuralgia and obturator neuralgia when women are referred to them with catastrophic pain syndromes from transobturator slings. This is despite specific knowledge that transobturator slings cause pudendal and obturator neuralgia immediately after placement or, in others, develop symptoms months or years after implantation.”
Dr. Vigna adds, “I represent several women, who prior to representation, were referred to defense experts with complaints of groin pain, symptoms of vulvodynia, tailbone pain, interstitial cystitis (IC), and anorectal pain following a transobturator sling (TOT). Seriously injured women with symptoms of pudendal and obturator neuralgia. The women were neither diagnosed with the pain syndrome they suffer with, nor were their complaints documented.”
Dr. Vigna concludes, “There should be accurate documentation of complaints and a serious conversation of the risk versus benefits of partial mesh removal versus risk versus benefits of complete mesh removal. If a woman has neuralgia and significant groin pain there should be a conversation regarding complete mesh removal because finding the mesh in the groin after a partial mesh removal is technically more difficult.”
The Vigna Law Group targets the below transobturator (TOT) slings and mini-slings that cause pudendal and obturator neuralgia:
- Ethicon: TVT-O, Abbrevo
- Boston Scientific: Obtryx, Solyx
- Coloplast: Aris, Altis
Dr. Vigna is a California and Washington DC lawyer who focuses on catastrophic neurological injuries caused by transvaginal mesh devices including pudendal neuralgia, obturator neuralgia, ilioinguinal neuralgia, and Complex Regional Pain Syndrome. He has clients with these diagnoses filed around the country with a team of national pharmaceutical injury trial attorneys.
To 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 click here. Click here for a FREE BOOK on Vaginal Mesh Pain and read this book for information regarding sling related complications: https://tvm.lifecare123.com/slingebook.html.
For articles, video resources, and information visit the Pudendal Neuralgia Educational Portal or visit https://tvm.lifecare123.com/.
Greg Vigna, M.D., J.D.
email us here
Visit us on social media: