NHS admits women have not always had the best care in mesh sling incontinence operations

PUBLISHED: 17:12 05 December 2015 | UPDATED: 17:46 05 December 2015

Sling The Mesh campaign

Sling The Mesh campaign

Archant

The NHS has admitted it has not been working with enough information about mesh used in operations to fix incontinence suffered by women.

A leading surgeon, brought in to oversee a mesh working group, said that women deserved the best possible advice and care but they had not always received it.

He recommended a range of steps including a mesh helpline and the same leaflets for use across the four countries of the UK to properly explain the operation risks.

The report comes following years of hard work by online campaigners from TVT Messed up Mesh who began in 2008, Meshies United and TVT Info.

Professor Keith Willett, director of acute episodes of care for the NHS, said issues had remained “unresolved for too long.”

A mesh kit used in the TVT or TVTO surgeryA mesh kit used in the TVT or TVTO surgery

He said: “The health system has not delivered that level of care consistently and has been working with an insufficiency of information for patients, clinicians, regulators and commissioners.

“Our current knowledge is insufficient. We must not be complacent and assume current evidence on risk and benefit tells the whole story.

“Much better evidence is on the horizon. Clinicians are already changing practice in response to the issues highlighted and patients voices have definitely resonated at all levels in ensuring future patients are better informed.

“We must continue to improve our knowledge and monitor emerging international evidence and safety reporting, always keeping an open mind as to the appropriate course of action on the appropriateness and role of implanted artificial mesh and slings.”

Professor Keith Willett, director of acute episodes of care for the NHSProfessor Keith Willett, director of acute episodes of care for the NHS

A 40 page interim report published this week says:

• There is evidence that complications, when they do arise, can be very severe and life-altering.

• A nurse helpline is needed to support women suffering mesh complications.

Kath Sansom has launched a campaign raising awareness about a gynaecology operation in which a TVT sling is used. Picture: HELEN DRAKEKath Sansom has launched a campaign raising awareness about a gynaecology operation in which a TVT sling is used. Picture: HELEN DRAKE

• Surgeons must be adequately trained to insert mesh and know what to do when a patient presents with problems.

• GPs need to know the full range of treatment options available via an e-learning package.

• Ensure surgeons report adverse incidents, which is not always done at the moment.

• Set up a one-off information gathering exercise to take account of patients’ experiences.

• Work out the cost of setting up a National Register so every woman who has a mesh is tracked for her lifetime

• Patient information leaflets, outlining risks, to be made standard across England, Scotland, Ireland and Wales

Mohammed Belal, a consultant urologist at the Birmingham Prostate Clinic, which deals with women’s and men’s urological problems, said: “I agree that greater awareness of this problem is crucial.

“My view is that all patients are offered alternatives, including using ones own tissue, especially in the younger population.

“Personally I feel that this view is not promoted well by most surgeons performing this surgery.

“If this was the case more patients would choose to use their own tissue for surgery when having it performed.

“Meshes do work in a significant number of patients without problems and a blanket ban would not be appropriate.”

Leading American surgeon Dr Shlomo Raz, who has removed 1,300 meshes from women suffering complications, including women who travel from the UK to his clinic in Los Angeles, said in a conference of the American Urological Association, that he abandoned using mesh two years ago.

He said he had seen too many patients suffering chronic pain and difficulty having sex after a mesh and around 20% of women suffering systemic reactions including arthritis, unexplained rashes, loss of hair and sinus problems.

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