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Transvaginal Implant Injury form

Fields marked with a * are required.

 
Implant Manufacturer*
American Medical Systems
Boston Medical Systems
Caldera
C.R. Bard
Ethicon
Johnson & Johnson
Mentor Corp
Sofradium
Tyco
Other
Unknown
 
Post Surgical Problems*
Pain
Infection
Pain During Sex
Pelvic Organ prolapse
Erosion of Vaginal Tissue
Stress Urinary Incontinence
Organ Perforation (puncturing) from surgical tools during implant
 


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