The New Land Down Under
In the Federal Court this week, more than 700 women suffering debilitating pain and disruption to almost every aspect of their lives as a result of vaginal mesh implant launched a class action against global healthcare giant Johnson & Johnson.
The implants, intended to treat pelvic floor damage in about 8000 Australian women, have resulted in life-altering complications, according to Rebecca Jancauskas from Shine Lawyers, who are running the class action.
“The complications that Australian women are suffering include the mesh or tape eroding through, and into, surrounding tissue and organs, as well as incontinence, infection and chronic pain,” she told media outside the court in Sydney prior to the opening of the class action.
Johnson & Johnson’s lawyers are to present their arguments next Monday (July 10), and hearings are expected to run for about six months.
“Many now live in excruciating pain, suffering terrible side effects that impact all aspects of their lives,” Rebecca said.
“This class action is about righting the wrong against these women, who will suffer pain and complications for the rest of their lives.”
Involved in the action is Perth woman Stella Channing* (see more about her ordeal in the breakout, The Vagina Mesh “Scandal” breakout below) described to Fairfax Media the “total destruction” of her life as a mesh implant, intended to treat post-childbirth prolapse, slowly disintegrates inside her.
Less than five years ago the only option for women in Australia suffering vulvo/vaginal dysfunctions such as pelvic prolapse or urinary incontinence, or dissatisfaction with the appearance of their genitalia (eg. labia), was surgical intervention.
Other internal issues such as vaginal atrophy and dryness suffered to varying degrees as a result of such hormonally-based life events (eg. naturally occuring or chemotherapy-induced menopause), which can have a profound impact on a woman’s sexual identity and intimate relationships (existing or potential), were not even treatable with surgery.
They were either reliant on hormone replacement therapies, such as topical or oral oestrogen supplementation. These methods are not always desirable for a woman due to unwelcome systematic side effects (eg. weight gain, fluid retention, breast swelling or tenderness); way less so, or totally out of the question, for women who have undergone treatment for oestrogen-related cancers.
Then there are and were lubricants, but which do not always provide the degree of relief or satisfaction needed.
Where surgery was an option, it was not always wanted or, indeed, accessible.
THE NEW LAND DOWN UNDER
The J&J class action has brought renewed light to the options available to women seeking vulvo/vaginal correction, rejuvenation or aesthetic enhancement in 2017.
Surgery is now far from the only one – hastening to add that procedures like vaginoplasty and labiaplasty are not to be seen in the same light as vaginal mesh implant surgery
In the past five years in Australia we have seen non-surgical device technology harnessing either laser, radio frequency or ultrasound energy providing women with minimally invasive treatments that are short in duration with little to no downtime. Furthermore, can produce the desired results in a matter of days (though more likely a few weeks or even months, and several treatments may be required) that are reported to be utterly life-changing.
Dr Mark Magnusson, founder and director of Toowoomba Plastic Surgery and Allure Clinic, began trials with ThermiVa RF vaginal rejuvenation technology in May last year, and has been regularly performing the treatment at Allure Clinic since last August.
But he is concerned by the strange taboo that surrounds creating discussion around such issues, which is turn is hampering generating greater awareness of the technology and potential to literally change lives.
He points outs that far too many women are either too afraid or embarrassed to discuss issues like vaginal atrophy and dryness or urinary incontinence with anyone, even a doctor.
Cultural mores may be another key the reason, or a woman simply believing she has to put up with debilitating symptoms because they are just a normal part of life and there’s nothing to be done about it.
“My patients who have been treated with ThermiVa love it,” he says. “It is hard to create awareness, however, as so many women have no real idea that such treatment options exist.
“The great thing about ThermiVa [a radio frequency device] is that there is a wide range of suitable candidates and the results this treatment achieves can be completely life-changing.
“These candidates include young women who have concerns with the aesthetics of their labia, women who are six weeks’ post-vaginal birth who have concerns with vaginal laxity and some urinary incontinence, women who are going through menopause and who suffer symptoms such as atrophic vaginitis and a decrease in sensation.
“This is a very sensitive subject for a lot of women and the majority are embarrassed to even raise the topic. A high percentage who would be ideal candidates are not even aware that treatments such as the ThermiVa are available to help with symptoms that they have, and may have had for many years.
“The procedure is very well tolerated with a gentle warning sensation being felt. It is minimally if at all painful, with no downtime. The recommended treatment regimen is three treatments spaced 3-6 weeks apart, with maintenance of one treatment required every 12-18 months or as symptoms start to return.
“Patients may notice an immediate improvement after each treatment, though this improvement is likely to decrease within the first week. It is the long lasting effect of new collagen production in the treatment area which is the result we are wanting and this result can take up to three months after the third and final treatment to be completely noticeable. “
OTHER VAGINAL REJUVENATION DEVICES TO CONSIDER
THE VAGINAL MESH “SCANDAL”
The Australian class action comes after more than 100,000 women started legal action in the US and similar moves were taken in the UK and Canada.
Women from across Australia are emerging to tell their stories as a Senate inquiry gathers evidence into what Senator Derryn Hinch described as “one of the greatest medical scandals and abuses of mothers in Australia’s history”.
Stella Channing (*as mentioned in the lead story) suffered from pelvic organ prolapse in her late 40s after having three children. A surgeon recommended surgery involving a “small amount of tape” between her rectum and vagina, requiring an overnight stay in hospital and a few weeks off her full-time retail job.
She woke with two bodies of mesh – Johnson & Johnson Ethicon Prolift, now removed from sale – between her rectum and vagina. She was in hospital for eight days.
One week after discharge, the mesh had begun to erode. She began experiencing bleeding, and pain in her buttocks and legs. Her surgeon could not recommend any solution.
Stella could not go back to work for three months and when she did, she could not stay on her feet. Her employers created a position as a customer service officer, so she could sit on a cushion in the office.
By 14 months after surgery, after dipping for a time, the pain returned full force, in her buttocks, rectum, vagina and thighs. She began experiencing transient ischaemic attacks, or “mini strokes”.
She was forced to drop work to part-time, then two days a week. She had to leave her job despite her employers’ efforts to accommodate her, being unable by then to sit down on an office chair.
Before the mesh implant, Stella was a healthy, active woman studying after hours to become a personal trainer.
The mesh had continued to erode and shrink, she said, shrinking her vagina and hardening her rectum, trapping and scarring the pudendal nerves running through the rectum and legs, damaging the flesh and muscles throughout the pelvis.
It was now close to piercing her rectal wall and causing blood poisoning.
“The nerve pain is like petrol burning inside me,” she told Fairfax media.
“The raw pain of the erosion is like broken glass in your rectum and vagina. As we speak I am losing blood from my rectum and vagina and the pain is unbearable. This has totally destroyed my life. It sounds dramatic – and I can only say that it is.”
Ms Channing cannot walk around the supermarket without a cane and must lie almost continuously on her side in a hammock-like bed. She cannot pick up her grandchildren, or even play with them.
“I was a gym junkie,” she says. “I would exercise every day. I wouldn’t even sit till to watch a movie. I was active, busy and social. I was someone who looked after my appearance. All that has been stolen.
“I am financially ruined. I lie down all day. I am isolated. Sometimes I cannot shower because the pain flare will be so great it will take days to recover.”
Some days, she tried to pick herself up and give herself a talking to. She would get up, do her hair, put makeup on and go to see her grandchildren.
Afterwards she would be rewarded with pain so unbearable it was like a punishment for her effort.
Stella says her older sons and grandchildren feel her absence, as does her ageing mother, who she can’t visit as it would involve flying to Adelaide.
But she worrieS most about her youngest child, her 23-year-old daughter who still lives with her. “She feels the burden of looking after me,” Stella says
“The other day she got back from a walk and just said, ‘Mum, we should be doing these things together’. I can’t go for walks with her, or to the gym, even out to breakfast. So she is missing out on having a mother who is involved in her life.
“I become depressed, hopeless, knowing I must live with this for the rest of my life.
“Some days, I wake up and don’t know why I have bothered waking up. Sometimes I think it would be better if I just didn’t.