ACOG and AI in Women’s Health: Evaluating When Patients May Turn to Technology Versus Gynecologists for Guidance

Dr. Greg Vigna

LOS ANGELES, CA, UNITED STATES, May 5, 2026 /EINPresswire.com/ -- “Some ACOG members may be less familiar with research indicating that pudendal neuralgia can be associated with soft tissue impacts from mid-urethral slings marketed in the United States," states Greg Vigna, MD, JD, national pudendal neuralgia lawyer.

Dr. Greg Vigna, MD, JD, Board Certified in Physical Medicine and Rehabilitation, states, “There is ongoing discussion within the medical community regarding the extent to which members of the American College of Obstetrics and Gynecology (ACOG) review position statements and supporting literature related to neurological pain syndromes linked to polypropylene mid-urethral slings. Published data has also noted that, to date, there are limited reported cases of pudendal or obturator neuralgia associated with slings made from PVDF, which may have not cause the chronic inflammation seen with the 1950s-era polypropylene."

What does AI say about the question, "Does a properly positioned transobturator sling cause pudendal neuralgia?":

“''Mechanisms of Injury from ‘Properly Positioned Slings’

Medical literature and clinical reports highlight that the mesh itself, or the body's reaction to it, can trigger neuropathy without direct nerve transection.

Secondary Muscle Spasms: The TOT sling pierces the obturator internus muscle. Mechanical irritation from the mesh can trigger chronic muscle spasms. Because the pudendal nerve runs within Alcock’s canal (a tunnel formed by the fascia of the obturator internus), a spasming muscle can indirectly compress the nerve.”

Dr. Vigna states, “ACOG has published guidance on a range of women's health procedures, however, some clinicians and researchers have raised questions about how emerging evidence related to devices such as morcellators, Essure, vaginal mesh, and polypropylene mid-urethral slings is incorporated into clinical practice. Additional topics of discussion in the literature include Depo-Provera and reported associations with meningiomas."

Dr. Vigna reflects on his time at Tulane Medical School, “During my medical training, I observed a wide range of academic performance among students entering obstetrics and gynecology. Since 2009, position statements and the literature have explored a potential link between transobturator slings and indirect nerve injury or pain affecting the obturator and pudendal nerves. Proposed mechanisms include chronic inflammation from polypropylene, which may contribute to muscle sasm and scar tissue formation, as described in international studies."

Some studies have reported an increased risk of myofascial pain with transobturator slings compared to retropubic slings. Clinical findings such as allodynia on physical examination have been identified in the literature as potential indicators of neuralgia (CRPS Type 2) or Complex Regional Pain Syndrome Type 1. Additionally, CRPS may be associated with dystonia."

Dr. Vigna continues, “To date, the American College of Obstetricians and Gynecologists (ACOG) has not recommended a ban of Depo-Provera. Some studies have explored associations between Depo-Provera and meningiomas, including cases involving multiple tumors, while alternative medications with comparable effectiveness are available."

Dr. Vigna adds, “Ongoing evaluation of the risks and benefits of medications and procedures remains important. Continued review of peer-reviewed literature, including independent studies, may support informed clinical decision-making."

Dr. Vigna’s final recommendation, “Patients should continue routine care, including Pap smears, and consider reviewing available medical information when discussing gynecological concerns."

Click here to read the ACOG guide of shared decision making: https://www.acog.org/clinical-information/patient-education-materials/tools-for-navigating-discussions/counseling-guides/birth-control-injection

Watch Dr. Vigna’s latest episode on Justice with Dr. V: Altis Mini- Sling Study Findings 2025 - Expert Review for Stress Urinary Incontinence Device

Dr. Vigna is a California and Washington D.C., lawyer and is Co-Counsel with the Ben Martin Law Group, a national pharmaceutical injury law firm in Dallas, Texas. The attorneys are product liability and medical malpractice attorneys, and they represent women who have suffered meningiomas.

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Greg Vigna, MD, JD
Vigna Law Group
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