May 2013

A 2004 article published in The Journal of Arthroplasty has shown that tiny metal particles (less than one micrometer in diameter) can be found in over 73% of people who used a metal-on-metal hip implant.  This research, conducted by Robert M. Urban et al. is titled “Accumulation in Liver and Spleen of Metal Particles Generated at Nonbearing Surfaces in Hip Arthroplasty” and is available in part online.

The Urban et al. (2004) study performed a postmortem analysis of the livers of 15 patients with all-metal hip replacement systems and using high-powered electron microscopes, found that 11 of those 15 patients had metal particles from their hip implant in the liver.  These particles enter the blood stream when the metal joint wears down, and “Fretting at ancillary fixation devices, loose components, and modular connections can generate a substantial volume of debris.”[1]

Since metal-on-metal hip implants are relatively new, Urban writes that “The long-term effects of accumulated wear particles in the liver and spleen are unknown.”[2]

The Orthopedics page at About.com provides some particularly insightful information on the subject:

“The concern about some metal-on-metal hip replacements, specifically one implant made by a Johnson & Johnson Company called DePuy Orthopaedics, is that implants were causing problems within the first few years after replacement. The problem found is that while the materials don’t wear out quickly, they do create microscopic particles of metallic debris. The body seems to react to this microscopic debris with an immune response.”[3]

This idea, that the body’s immune system reacts to the foreign metal debris was corroborated by Urban’s 2004 study cited above, which found that “metal particles were identified within macrophages in the liver and/or the spleen”[4] in patients with all-metal hip replacements.  For general information on the role of macrophages in the human immune system, follow the link above.  For a more detailed picture of the role of macrophages, review this article.

The immune response to the metal debris “can lead to soft-tissue and bone damage around the hip joint. In some patients, this tissue damage has been severe causing permanent injury and requiring additional surgery.”[5]  For this article on the danger of metal-on-metal hip replacements, the Orthopedics page cited research published in a 2012 edition of The Lancet.

If you or a loved one has a metal-on-metal hip replacement system and have experienced negative side-effects as a result, you may be entitled to financial compensation for your injuries through a metal-on-metal hip lawsuit.  For a free case consultation, contact our team of hip replacement defect lawyers.

At your convenience, you may reach our offices by phone at (855) 452-5529 or by e-mail at justinian@dangerousdrugs.us.


[1] Urban, RM et al “Accumulation in Liver and Spleen of Metal Particles Generated at Nonbearing Surfaces in Hip Arthroplasty” The Journal of Arthroplasty Vol. 19 No. 8 Suppl. 3 2004

[2] Ibid.

[4] Urban, RM et al “Accumulation in Liver and Spleen of Metal Particles Generated at Nonbearing Surfaces in Hip Arthroplasty” The Journal of Arthroplasty Vol. 19 No. 8 Suppl. 3 2004

Recently (2012) an article published in Obstetrics and Gynecology has reviewed the frequency with which complications surrounding surgery occur as well as how often reoperation is required following “prolapse repairs using mesh and biologic grafts.”[1]

By analyzing “all female members of [the healthcare provider] Kaiser Permanente Southern and Northern California and Hawaii who underwent sling procedures or pelvic organ prolapse surgeries using implanted grafts or mesh between September 1, 2008, and May 31, 2010,”[2] the Nguyen et al. (2012) team was able to secure 4,142 test subjects whose mean age was 57, and who in all underwent “3,747 slings and 1,508 prolapse repair procedures using implanted prostheses,”[3] such as transvaginal mesh.  Transvaginal mesh can be made of several substances, most commonly polypropylene or silicone.  Recently, it has been documented that silicone mesh causes vaginal mesh erosion more than 20% of the time, and that polypropylene transvaginal mesh causes vaginal mesh erosion more than 10% of the time.

While this study found that mesh erosion occurred less frequently in this group of people, the authors still stated that “Reoperations for mesh-related complications occured most often after transvaginal mesh placement in the anterior vagina,”[4] a common site for the use of transvaginal mesh in the repair of pelvic organ prolapse.

Due to the fact that several manufacturers of transvaginal mesh have failed to adequately warn doctors and patients of the risks associated with transvaginal mesh, a number of transvaginal mesh lawsuits are currently being filed.  If you used transvaginal mesh and experienced a mesh-related infection, vaginal mesh erosion, or another transvaginal mesh side effect, you may be entitled to financial compensation for the injuries you have sustained through no fault of your own.  For more information, please do not hesitate to contact our team of vaginal mesh lawyers.

For a free, no-obligation case consultation, you may contact our offices by phone at (855) 452-5529 or by e-mail at justinian@dangerousdrugs.us.  Call today and see how we can help!


[1] Nguyen, JN et al. “Perioperative Complications and Reoperations After Incontinence and Prolapse Surgeries Using Prosthetic Implants” Obstetrics and Gynecology Vol. 119, No. 3. March 2012. 539-46

[2] Ibid.

[3] Ibid.

[4] Ibid.

A report titled “Dyspareunia and chronic pelvic pain after polypropylene mesh augmentation for transvaginal repair of anterior vaginal wall prolapse” published in a 2007 edition of The International Urogynecology Journal by Lawrence L. Lin et al. illustrates the case of one woman who used transvaginal mesh following pelvic organ prolapse and suffered particularly unfortunate side-effects.

While the risk rate for vaginal mesh erosion has been found to be as high as 20% by some studies, and other studies have linked vaginal mesh use to an increased risk for bacterial infections, few have illustrated well the side effects of dyspareunia and/or chronic pelvic pain, ailments that effect many users of transvaginal mesh.

The woman discussed in the Lin et al. paper was 55-years-old at the time of her pelvic organ prolapse repair surgery that required the use of a 6 x 4 cm piece of polypropylene transvaginal mesh.  Previous studies have found that polypropylene transvaginal mesh results in vaginal mesh erosion at a rate of 10-13%.  At the time she presented to Lin et al., she was 59-years-old and had been experiencing chronic, debilitating pelvic pain for years, and had more recently begun experiencing dyspareunia.[1]

Here is an excerpt from the Lin et al. paper where Lin discusses the course of this woman’s treatment:

“We opted to treat the patient conservatively with more vaginal estrogen therapy and oral anti-inflammatory medications for 4 months. … After extensive counseling with the patient about the risks and the benefits of surgical excision, we believed that the risks of surgery outweighed the benefits and we recommended that conservative management was her best option. The patient’s chronic pelvic pain symptoms remained persistent and unchanged after conservative treatments, and she failed to keep further follow up appointments.”[2]

Commenting on this case more broadly, Lin et al. write “In our case report, the 6×4-cm polypropylene mesh was adherent to the base of the bladder. The anatomic support of the synthetic mesh in the anterior compartment was excellent; however, the patient’s chronic pelvic pain and dyspareunia were now more debilitating than her previous bladder prolapse,”[3] suggesting that using transvaginal mesh to correct a medical condition may be more painful and debilitating than the condition itself.

As a result of such high rates of complications associated with transvaginal mesh and a lack of sufficient risk rate disclosure on the part of transvaginal mesh manufacturers, many transvaginal mesh lawsuits are currently being filed.  If you used transvaginal mesh and experienced side effects such as those described above, vaginal mesh erosion, or mesh-related infection, you may be entitled to financial compensation for your injuries.

For a free case consultation, contact our team of transvaginal mesh lawyers either by phone at (855) 452-5529 or by e-mail at justinian@dangerousdrugs.us.

Our Transvaginal Mesh Lawsuit Information page is a great place to start if you have additional questions about Transvaginal Mesh.


[1] Lin, LL et al. “Dyspareunia and chronic pelvic pain after polypropylene mesh augmentation for transvaginal repair of anterior vaginal wall prolapse” Int Urogynecol J (2007) 18:675–678

[2] Ibid.

[3] Ibid.

In 2009, research was published in The Journal of Urology demonstrating that there is considerable increased risk for infection associated with the use of transvaginal mesh (TVM).  Transvaginal mesh is a synthetic substitute for human tissue, usually made of either polypropylene or silicone that is used in the repair of damaged organ walls as a result of pelvic organ prolapse.

This research was conducted by Caroline Elmer et al., and data for this project was collected by analyzing the number of macrophages found on or near transvaginal mesh.  Macrophages are cells part of the body’s immune system, eating and digesting foreign particles or bacteria to clean the bloodstream.  So, the more macrophages found at a certain cite in the body, the more bacteria that are likely to be present as well.  For more information about macrophages and the immune system, follow the link above.

Studying ten patients who used polypropylene transvaginal mesh and comparing the macrophage count to eight control subjects, Elmer et al. found “a significant postoperative increase in macrophage and mast cell counts,”[1] and concluded that “When used for pelvic reconstructive surgery, macroporous monofilament polypropylene mesh induces a mild but persistent foreign body reaction.”[2]

Due to the small size of this study, more data must be collected on this topic before definite conclusions may be made.  Other studies published about the same time, however, also link use of transvaginal mesh and increased risk of bacterial infection, and it must not be overlooked that the Elmer et al. study illuminates a serious complication of transvaginal mesh use and helps to point future research in a potentially fruitful direction.

As a result of the well-documented high risk for vaginal mesh erosion associated with transvaginal mesh use, and the high number of adverse events reported to the FDA, a number of transvaginal mesh lawsuits are currently being filed.

If you or a loved one used transvaginal mesh and experienced transvaginal mesh erosion or mesh-related infection, please do not hesitate to contact our team of transvaginal mesh lawyers for a free case consultation.

By phone, you may reach our offices at (855) 452-5529, and by e-mail, you may reach our offices at justinian@dangerousdrugs.us.  Our firm has the experience, resources, and skills required to win the justice you deserve.  Call today and see how we can help!

Our Transvaginal Mesh Lawsuit Information page is a great place to start if you have additional questions about Transvaginal Mesh.


[1] Elmer, C. et al. “Histological Inflammatory Response to Transvaginal Polypropylene Mesh for Pelvic Reconstructive Surgery” The Journal of Urology Vol. 181, Issue 3. Pages 1198-1195, March 2009

[2] Ibid.

A 2009 report published in the International Urogynecology Journal shows clearly that the risk for bacterial infection is dramatically increased with the use of transvaginal mesh, a popular synthetic substitute for human tissue used in surgical repair following pelvic organ prolapse and other ailments.  While transvaginal mesh has previously been found to cause vaginal mesh erosion at a rate of between 10 and 20%, only little research has been conducted on the connection between TVM use and increased risk for infection.

The study team, lead by Astrid Vollebregt, evaluated the amount of bacteria on the transvaginal mesh implants of 64 consequtive women,[1] and “In 56 (83.6%) [transvaginal mesh] implants, a positive culture with vaginal bacteria was found”[2].  Clearly, this rate of complication is exceedingly high.

While this study does not on its own prove that transvaginal mesh use creates an increased risk for bacterial infection, it may be used as a springboard for future research on this topic.  And further, this article may be used in a transvaginal mesh lawsuit to help illustrate the scope of the negative side-effects caused by transvaginal mesh use.

In fact, many transvaginal mesh lawsuits are currently being filed due to the fact that several transvaginal mesh manufacturers have failed to adequately warn users about risks well-documented to be associated with TVM, such as vaginal mesh erosion.  If you or a loved one used transvaginal mesh and experienced vaginal mesh erosion or mesh-related infection, you may be entitled to significant financial compensation for your injuries.

For a free case consultation, contact our team of transvaginal mesh lawyers by phone at (855) 452-5529 or by e-mail at justinian@dangerousdrugs.us.

Our Transvaginal Mesh Lawsuit Information page is a great place to start if you have additional questions about Transvaginal Mesh.  We are here to help!


[1] Vollebregt, A. et al. “Bacterial colonisation of collagen-coated polypropylene vaginal mesh: are additional intraoperative sterility procedures useful?” Int Urogynecol J (2009) 20:1345–1351

[2] Ibid.

In 2007, medical researchers Matthew E. Falagas et al. published a report outlining bacterial infections that may occur as a result of transvaginal mesh use.  To clarify, transvaginal mesh (TVM) is a man-made substitute for human tissue that is used in the surgical repair of a damaged uterine or vaginal wall usually following pelvic organ prolapse.

To compile data for the report, Falagas et al. reviewed the national medical research database curated by the National Institutes of Health, PubMed, for articles regarding “the incidence, clinical manifestation, and management of vaginal mesh-related infections.”[1]

From their research, Falagas et al. found that mesh-related infections occurred as high as 8% of the time, while vaginal mesh erosion occurred at a rate as high as 33% in some studies.[2]

Signs that one has a transvaginal mesh-related infection are “Non-specific pelvic pain, persistent vaginal discharge or bleeding, dyspareunia, and urinary or faecal incontinence.”[3]  And though most mesh-related infections may be cured with antibiotics, many women face these risks unknowingly due to the fact that several transvaginal mesh manufacturers have failed to warn physicians of the rates at which these complications occur.

As a result of this, a number of transvaginal mesh lawsuits are currently being filed either as a result of a patient’s experiencing vaginal mesh erosion or mesh-related infection through no fault of their own.  If you used transvaginal mesh and experienced one of these complications or another TVM side effect, please do not hesitate contact our team of Transvaginal Mesh Lawyers for you may be entitled to significant financial compensation.

At your convenience, you may reach our offices by phone at (855) 452-5529 or by e-mail at justinian@dangerousdrugs.us.  Our Transvaginal Mesh Lawsuit Information page is a great place to start if you have additional questions about Transvaginal Mesh.


[1] Falagas, ME et al. “Mesh-related infections after pelvic organ prolapse repair surgery” European Journal of Obstetrics & Gynecology and Reproductive Biology 134 (2007) 147–156

[2] Ibid.

[3] Ibid.

In 2009, Robert M. Freeman and Gunnar Lose published a report aiming to weigh the benefits against the risks associated with transvaginal mesh use.  Transvaginal mesh (TVM) is a synthetic tissue substance used in the surgical repair of the vaginal or uterine wall following pelvic organ prolapse or another such ailment.

Published in The International Urogynecology Journal, the Freeman and Lose (2009) report was titled simply “The great mesh debate” and begins by asserting that there is an insufficient amount of research regarding transvaginal mesh to conclude anything about its safety: The evidence for most efficacy and safety outcomes was too sparse to provide meaningful conclusions about the use of mesh/graft in anterior and/or posterior vaginal wall prolapse surgery”[1]

Freeman and Lose suggest, rather, that the use of TVM “should be considered experimental … until such evidence is available that patients can be [counseled] accordingly.”[2]

Here is an excerpt from the report I found particularly poignant:

“The rationale for the use of mesh relates to the poor outcomes of traditional prolapse surgery especially for the anterior compartment. [Prominent medical researcher]Te Linde stated over 40 years ago that: ‘every honest surgeon of extensive and long experience will have to admit that he/she is not entirely and absolutely satisfied with his/her long-term results of his/her operations for prolapse and allied conditions’ [7]. It could be argued that not much has changed with 40% failure rates being quoted for anterior repair [8].”[3]

Though to be fair, Freeman and Lose also acknowledge “that it is relatively easy to publish a case report of a severe complication but that this can paint a falsely pessimistic picture.”[4]

However, the evidence that TVM use is dangerous and causes unnecessary complications is clear: about 20% of women that use TVM will require a second surgery to correct complications caused by the first procedure.[5]  “While these re-operation rates are not synonymous with failure, nonetheless, one would imagine that if after ‘failed’ primary surgery the symptoms were bothersome then patients would seek further treatment, whether that be with vaginal pessaries or surgery.”[6]

Suggesting that gynecologists around the country keep records of all “good” and “bad” outcomes of TVM use, Freeman and Lose write that eventually, doctors will be able to adequately inform patients about the safety of TVM.  In the meantime, we can plainly examine the available data: it is now widely-known that TVM use results in vaginal mesh erosion at least 10% of the time.

Due to the fact that many TVM manufacturers have failed to warn users of these risks, a number of transvaginal mesh lawsuits are currently being filed.  If you used TVM and experienced vaginal mesh erosion or another TVM side effect, please do not hesitate to contact our team of TVM lawyers.

For a free consultation, you may reach our offices by phone at (855) 452-5529 or by e-mail at justinian@dangerousdrugs.us.

Our Transvaginal Mesh Lawsuit Information page is a great place to start if you have additional questions about Transvaginal Mesh.


[1] Freeman, RM & Gunnar, L “The great mesh debate” Int Urogynecol J (2009) 20:889–891

[2] Ibid.

[3] Ibid.

[4] Ibid.

[5] Ibid.

[6] Ibid.

A 2008 report by Dr. Assia A. Stepanian et al. published in The Journal of Minimally Invasive Gynecology has outlined some of the complications associated with use of transvaginal mesh (TVM), a synthetic substitute for human tissue used in surgical repair of the uterine or vaginal wall following pelvic organ prolapse.  As of yet, polypropylene TVM products have been associated with a rate of complication over 10%, with silicone transvaginal mesh products’ complication rates exceeding even 20%.

The Stepanian et al. (2008) piece was titled “Risk of Mesh Extrusion and Other Mesh-Related Complications After Laparoscopic Sacral Colpopexy with or without Concurrent Laparoscopic-Assisted Vaginal Hysterectomy: Experience of 402 Patients” and may be found online by following the link above.

As vaginal mesh erosion is the most common complication of transvaginal mesh use, it is understandable that this was the focus of the Stepanian (2008) piece.

Of the 402 patients studied, only about 1.2% experienced vaginal mesh erosion or TVM extrusion.[1]  This surprisingly low figure may, however be due to the fact that the 402 patients studied had all undergone sacral colpopexy, while studies finding rates of vaginal mesh erosion over 10% included any and all uses of transvaginal mesh.

Due to the fact that over 1000 adverse events related to transvaginal mesh use have been reported to the United States Food and Drug Administration, and a number of transvaginal mesh manufacturers have failed time and again to warn users of the risks and frequency of risks associated with the use of their products, a number of TVM lawsuits have been filed.

If you used transvaginal mesh and experienced a negative side effect such as vaginal mesh erosion, please do not hesitate to contact our team of transvaginal mesh lawyers.  You may be entitled to significant financial compensation on your behalf due to the lack of oversight at these companies that caused your injuries.

For a free, no-obligation case consultation, you may reach our offices either by phone at (855) 452-5529 or by e-mail at justinian@dangerousdrugs.us.

We have the experience, resources, and skills required to fight even the largest companies for the justice you deserve.  Our Transvaginal Mesh Lawsuit Information page is a great place to start if you have additional questions about Transvaginal Mesh.


[1] Stepanian, A.A. et al. “Risk of Mesh Extrusion and Other Mesh-Related Complications After Laparoscopic Sacral Colpopexy with or without Concurrent Laparoscopic-Assisted Vaginal Hysterectomy: Experience of 402 Patients” Journal of Minimally Invasive Gynecology 2008 Mar-Apr;15(2):188-96.

A 1998 report published in Obstetrics and Gynecology titled “Mesh erosion after abdominal sacrocolpopexy” by Dr. Neeraj Kohli et al. illustrates clearly an all-too-common complication of transvaginal mesh use.

Transvaginal mesh (TVM) is synthetic “tissue” used to “mimic,” if you will, human flesh, used in the surgical reconstruction of the vaginal or uterine wall following pelvic organ prolapse or another similar ailment.  In the last 15 years, however, a great number of reports have been published that show an extremely high rate of severe complications related to transvaginal mesh use, the most common of which is vaginal mesh erosion.  Vaginal mesh erosion occurs in 10% of women who used polypropylene TVM; 23.8% of women experienced vaginal mesh erosion with silicone TVM.

In 1998, Kohli et al. performed a retrospective analysis of patients who had undergone sacrocolpopexy by one surgeon in an 8 year period.  Of the 57 patients who had undergone that surgical procedure between 1990 and 1998, 12% “had erosions,”[1] and the mean time it took for erosions to occur was 14 months.[2]

Though this research was published 15 years ago and clearly shows a high rate of complication accompanying the use of TVM, and though other many studies have reached similar conclusions about the risks associated with transvaginal mesh, many manufacturers of TVM products have yet to provide warning labels explaining these risks.

As it currently stands, over 1000 reports of adverse events related to transvaginal mesh have been made to the United States Food and Drug Administration; prompting the re-evaluation of 56 TVM products by 5 manufacturers.

If you or a loved one used transvaginal mesh and experienced vaginal mesh erosion or another TVM side-effect, you may be entitled to significant financial compensation through a transvaginal mesh lawsuit.  At your convenience, you may contact our team of transvaginal mesh lawyers for a free case consultation at (855) 452-5529 or by e-mail at justinian@dangerousdrugs.us.

We have the experience, resources, and skills required to secure the justice you deserve.  Call today and see how we can help.  Our Transvaginal Mesh Lawsuit Information page is a great place to start if you have additional questions about Transvaginal Mesh.


[1] Kolhi, N et al. “Mesh erosion after abdominal sacrocolpopexy” Obstetrics & Gynecology Volume 92, Issue 6, December 1998, Pages 999–1004

[2] Ibid.