Surgeons admit there is serious under-reporting of mesh complications as a new survey outlines the devastating risks of a “quick fix” operation
- Credit: Archant
Surgeons have been criticised for failing to report mesh implant problems, which for years has hidden the scale of suffering, in what is being called the biggest health disaster since Thalidomide.
In a damning You Tube video of a surgeon conference, medics are heard saying they are too busy to report, can’t work out new IT systems and evidence is low quality.
Some hospitals have recorded nothing at all, while one consultant asked why they had to log data.
Another said that with the number of mesh cases coming to court, there will be a few “nervous” gynaecologists who haven’t recorded any evidence to back up their work.
The You Tube video shows that behind the scenes, surgeon societies know that mesh safety evidence is low quality and short term.
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Meanwhile, women across the UK are suffering life changing pain and loss of sex lives and surgeons continue to implant the plastic devices in a bid to get the long term evidence they need.
Campaigners say this continues to use women as human guinea pigs, despite patient safety groups globally testifying to the scale of personal tragedy.
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Many are forced to adjust to new normals having walked into what they were assured was a simple operation with minimal risks.
A survey of 570 members on campaign group, Sling The Mesh, shows the devastation of previously healthy women, offered a quick fix to an embarrassing problem of prolapse or incontinence, often caused by childbirth.
Now, they are left with problems including:
• Eight out of 10 suffer pain when walking.
• Eight out of ten report pain when sitting.
• Seven out of ten have lost sex lives.
• One in three struggle to go to urinate and have to self catheterise.
• More than half suffer nerve damage.
• One in three suffer erosion. This is where mesh slices into tissues, nerves, and organ like the bladder or bowel or through vaginal walls.
• Six out of 10 suffer depression and anxiety.
• More than half suffer ongoing cystitis. Urinary tract infections (UTI) need antibiotics to treat it. Over time, women are becoming antibiotic resistant, which poses a dangerous sepsis risk.
• Fourteen women are down to their last antibiotic that works, a further 14 are down to their final two. Once those stop, any future infections must be treated with high dose medication, on a drip in hospital.
• A third of women have had to give up work, while one in five are on reduced hours to cope.
• Seven out of ten say it has impacted their ability to enjoy hobbies and socialise with family and friends.
The NHS, MHRA and Government officials say the plastic mesh implants are a safe and effective treatment option, used in the right patient and inserted by the right surgeon.
UK health advisory body, NICE, this month said vaginal prolapse mesh should stop.
However, surgeon societies say it is still a safe option to treat incontinence providing women are told of the risks.
Sling The Mesh campaigners say complications are just as severe, whether it is a mesh patch to fix prolapse or a tape mesh sling to treat incontinence.
The survey shows that the incontinence operation is the most commonly performed. Statistics show:
• 70 per cent of women had an incontinence mesh tape.
• 20 per cent had a mesh patch to treat prolapse.
• 10 per cent had a mesh patch to treat a hernia.
In a conference earlier this year BAUS (British Association of Urology Surgeons) are heard criticising colleagues who are members of another society, BSUG (British Society of Urology Gynaecologists), about their poor data collection.
Chris Harding, urologist at Newcastle Hospital, says: “When you look at the response rate on the BSUG there’ll be a few nervous gynaecologists with all of the tape cases coming to court - where can they demonstrate that they contribute to national audit?”
Mr Harding adds there is: “A significant risk of bias” in reporting as it relies on surgeons to enter all their data in an accurate way and “it’s easy to lose the odd case.”
“This is not high level evidence,” he said. “There are some surgeons or units that don’t enter any data.”
Less then four out of ten surgeons report to the BSUG database, the largest system used to look at the number of women suffering mesh problems.
One surgeon asks what is the point of reporting while another commented there is currently only three months follow up of women and it needs to be done at one, five and 10 years.
Campaign groups globally say mesh is like a ticking time bomb as problems may not cut in until years later.
Mr Harding said that when the NHS English Mesh Review was carried out everybody went to look for long term data - but couldn’t find any.
Surgeon Roland Morley concludes: “The NHS Review will say we want long term follow up, we’ve got to push NHS England to pay for that.”
• Watch the 20 minute discussion here on You Tube BAUS Urological Challenges 2017. Watch from 1:23:2.
• Read the Sling The Mesh survey here.