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Vaginal Mesh Implants Can Be Used On NHS With Changes Says NICE

April 2, 2019

Controversial vaginal mesh implants can be offered again on the NHS in England once certain conditions are met, health watchdog NICE has said.

Some women have been left unable to walk, work or have sex after having the implants, which are used to treat pelvic organ prolapse and incontinence.

Use of vaginal mesh was halted across the UK last year amid safety concerns.

NICE said operations must be performed by specialist surgeons at specialist centres before their reintroduction.

All instances – and outcomes – of vaginal mesh operations should also be recorded on a national database “to help with future decision-making”, it said.

The NHS is not compelled to act on the guidelines – which are for England only – but services are expected to take NICE recommendations into account when planning and delivering care.

‘Disregarding women’

Under the new guidelines, each patient would receive a “decision aid” – detailing all the latest evidence on available treatments – and mesh implants would be used only after non-surgical options, such as lifestyle changes and pelvic floor training, had failed.

NICE said the “limited evidence” meant “the true prevalence of long-term complications following surgery with mesh is unknown”.

But Labour MP Owen Smith, who chairs a cross-party group of MPs on surgical mesh implants, told the BBC’s Victoria Derbyshire programme he was “deeply disappointed”.

“The updated guidelines appear to disregard mesh-injured women’s experiences by stating that there is no long-term evidence of adverse effects,” he said.

“Thousands of women have faced life-changing injuries following mesh surgery and they must not be ignored.”

He called for the continued suspension of vaginal mesh until an independent review – led by Baroness Julia Cumberlege – published its findings later this year.

Baroness Cumberlege told the Victoria Derbyshire programme now was not the time for the pause on vaginal mesh to end.

“We set five conditions that would need to be met before the pause could be lifted and the use of mesh could be contemplated,” she said.

“Those conditions have not yet been met and it is clear to us that it will be some considerable time before they are.

“This means that, now and for the foreseeable future, mesh should not be used to treat stress urinary incontinence, either in the NHS or the independent sector.

“The scale and intensity of this tragedy is truly shocking – lives have been ruined.”

Studies suggest as many as one in 10 patients can experience complications including chronic pain and difficulties walking.

‘I tried to kill myself’

Jackie Cheetham says she has tried to kill herself on several occasions because of the complications caused by her mesh implant.

“I have constant pain in my groin and down my leg,” she says.

“I don’t sleep at night. I can’t walk far. We’ve lost our house, as I couldn’t work anymore.

“It almost cost me my marriage.

“I have tried to overdose several times. I felt like an unfit mother. I couldn’t work and I thought, ‘What’s the point?'”

Ms Cheetham says when she had the implant – to treat incontinence – she was given a leaflet by her surgeon “but it definitely didn’t say I would be left in lifelong pain”.

And despite surgery to remove it, some mesh still remains inside her.

Campaign group Sling the Mesh founder Kath Sansom said the NICE guidelines were effectively “no different from what was published in 2003”.

“They are so weak – they clear the way for the next generation of women to be harmed,” she said.

Image caption Kath Sansom said adversely-affected women had been “ignored”

“We told our stories and NICE ignored us.

“Our Sling The Mesh survey shows one in 20 women have attempted suicide and more than half have regular suicidal thoughts because of chronic pain, loss of sex life, constant infections and autoimmune disease.”

An official at England’s Department of Health and Social Care said: “NICE’s new guidelines and patient decision aids on managing urinary incontinence and pelvic organ prolapse will help women make more informed choices about their treatment.

“The use of vaginal mesh was paused to ensure that patients receive a high-quality and consistent service.

“Mesh will still be a treatment for some women who understand the risks and following discussions with their consultant.”

The Royal College of Obstetricians and Gynaecologists (RCOG) and the British Society of Urogynaecology (BSUG) said they welcomed NICE’s recommendation “that the full range of non-surgical options should be offered to women before any surgical procedures” and “fully endorse” NICE’s patient decision aids.

But they added it was “important to note” that a period of “high-vigilance” remained regarding the implants’ use.

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4 Comments leave one →
  1. ANGIE permalink
    April 2, 2019 11:27 am

    Yet another example of how women’s health is disregarded and the NHS ignoring their failings. Its about time the NHS were made to take responsibility for their mistreatment of women, it is scandalous that they can keep causing harm and get away with it

  2. Aggie permalink
    April 2, 2019 12:31 pm

    All medical and surgical procedures have side effects. Living with severe incontinence can have a severe impact on quality of life, many too frightened to leave home due to embarassment and how large leakage can be perceived by others, some suicidal. Women are at greater risk of some types of incontinence than men, often after childbearing. Larger and larger pads are not the answer, when it is everyday and mugfuls not simply a few drops.
    Many women have been given their lives back after what was deemed a simple procedure compared to alternatives such as open colposuspension, which is major surgery., approximately 80 to 90 % at 1 year follow up.
    I feel for those who have suffered massive side effects from mesh implants. Unfortunately it was seen as a quick simple fix even for those with mild incontinence,with many more women being able to be treated than by conventional surgery. It is vital that medical research is allowed to continue into incontinence. In the past patients were given limited information before consenting, and often given no choice, that is doctor knows best! We must be treated as equals in decision making of this type, and offered all the alternatives, with the long term risks and benefits explained and given time to decide what is right for the individual.
    It is vital that effort is put into collecting long term data from those who have already had mesh implants.Too many have had procedures but lost to follow up post procedure.and when complications occured ignored and not referred to those specialists that could help remove the tape and give other care to treat a major problem.

    There are no easy fixes, living with severe incontinence is to say challenging .
    I was fortunate and had most of my mesh tape removed 6 years later. it never worked. Other procedures have also had long term problems, and I eventually had the open colposuspension.
    It is vital that we can make informed choices, but to do so we need research findings of properly carried out trials. Some one has to be the guinea pig, but it should be by choice.

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