Mesh implant complications leave some women feeling suicidal, pain management expert warns
PUBLISHED: 20:00 04 July 2018
A leading pain specialist has called for action to help women experiencing pain after mesh implants, some who suffer so badly, they consider suicide.
Andrew Baranowski, of the British Pain Society, says it is a basic human right for these women to have good quality pain management, yet there are probably only five centres in the UK which can deal with such complex problems.
Mr Baranowski said: “Put simply living with chronic pelvic pain is associated with a significant negative effect on mood, thoughts, behaviour, sexual and personal relations as well as employment.
“It increases the risk of depression and anxiety and is associated with increased suicidal risk as well as mortality from other conditions like cardiac problems.
“Access to pain management is a fundamental human right. Despite this there are only probably five specialised pelvic pain management services in England that would meet NHS specifications to provide specialist assessment and management of conditions.
“There are limited NHS resources for those that live with chronic pelvic pain. Many medics struggle to know how best to support and manage those living with it.”
Mr Baranowski, who attended the latest Mesh All Party Parliamentary Group, led by MP Owen Smith, added: “As well as the psychological responses of living with chronic pelvic pain these women live with the anger of what has happened to them, the frustration and emotions of not being believed and the distress associated with traumatic stress of what they have been through (PTSD).
“It is well established that traumatic emotions will increase the pain experience and that the pain will increase psychological traumatic experiences.
“Living with chronic pelvic pain following mesh insertion is well established. Whereas, how often it happens is not well recorded.”
“When it does happen it is clear that the pain can be intrusive to the extent that some consider suicide.”
“The complex journey these individuals follow post surgery will usually be associated with significant distress, depression, anger, and negative thoughts; as well as severely reduced physical and sexual activity, a negative impact on relationships and difficulty with maintaining employment.”
“There is limited published data on the incidence of chronic pain after mesh surgery but there is evidence it does occur and could be around 40 per cent of those with complications post mesh, if not higher.”
Mr Baranowski said there now needs to be proper pathways of care set in stone in NHS guidelines.
“Care should be in dedicated centres with specialist teams,” he said. “Including surgeons, colorectal physicians, pain physicians and teams of specialised nurses, psychologists and pain physiotherapists.
“Complex imaging and assessment is key. In certain cases, psychiatric support may be required.
“Specific guidelines need to be agreed. This will require NICE and NHS England Specialised Services working closely with the Royal Colleges and specialist Societies, such as The British Pain Society. There needs to be a plan for commissioning of such services.”