Women have been exposed to unacceptable risks through the use of vaginal mesh surgery, the UK government has acknowledged for the first time, as fresh evidence has revealed that thousands of women have suffered traumatic complications. The Guardian reports that in a parliamentary debate on the use of the implants, Jackie Doyle-Price, junior minister at the Health Department, said it was a “tragedy” that women who had put their trust in the medical establishment had “come out with the most debilitating injuries”.
“These products … should only be used as an extreme measure,” she added. “We should be very concerned by the extent to which these were adopted.”
Previously, the report says, the Health Department had stated that the benefits of vaginal mesh surgery outweighed the risks.
Labour’s Emma Hardy, who secured the parliamentary debate on the issue, led calls to suspend the use of surgical mesh and for the government to consider launching a full public inquiry, adding that doctors and patients had been “voting with their feet” on the surgery. The Kingston upon Hull West and Hessle MP said: “During the last nine years the figures show the number of women having the procedure has fallen by 48%, which to me says an awful lot about what the doctors are thinking about this. These women were injured, these women were ignored, these women are the victims of a scandal.”
Hardy cited figures from an NHS Digital report showing that for every 100 women who have a vaginal mesh procedure, 79 are subsequent gynaecology outpatients within a single year. She called for Nice guidelines for mesh in stress-related urinary incontinence to be brought forward from 2019 to 2018, and for pelvic floor physiotherapy to be routinely offered on the NHS to all new mothers. “There is also still no physiotherapy universally available for all new mothers as standard, as there is in France, to stop these problems before they even arise,” she said.
The report says MPs heard a series of harrowing accounts of constituents who had suffered life-altering complications due to surgery, including women left suicidal, of mesh embedded in pelvic tissue “like barbed wire”, of organs removed due to damage, loss of sex lives and the psychological trauma of being dismissed by doctors.
Sarah Wollaston, the Conservative MP and chair of the Health select committee, criticised “cavalier attitudes” to the adoption of medical implants and a “wild west” where mesh was aggressively marketed without having undergone clinical trials. “Many of the women that I have met, as I say, have had profound, life-changing injuries and I think they are entitled, many of these women, to compensation,” she added.
Labour’s Owen Smith, chair of the All-Party Parliamentary Group on surgical mesh, said there had been almost 1m outpatient appointments linked to vaginal mesh, with costs to the NHS somewhere in the region of £250m. A so-called “failure rate” of between 1% to 3% was not acceptable anyway, Smith said, adding that the numbers “are far greater than that”.
The report says government figures show that about 500 removal surgeries for vaginal mesh have taken place every year for the past decade. The initial keyhole surgery, usually takes less than half an hour and involves inserting a plastic mesh into the vagina to support the bladder, womb or bowel and pelvic floor muscles. However, reversing the procedure can involve open surgery that is risky and complex since the mesh becomes embedded in muscle and sometimes attached to pelvic organs.
The latest figures imply much higher complication rates than those previously reported in both industry-funded trials and a 2014 government report assessing the risks and benefits of vaginal mesh, which estimated the removal rate for TVT at 0.9% and the rate of complications, such as pain, at below 1.5%.
Owen Smith MP, chairman of the All Party Parliamentary Group (APPG) on surgical mesh, said: “These statistics show that the scale and complexity of the problems associated with mesh is far greater than has previously been accepted.
The report says the government has asked Baroness Julia Cumberledge to investigate concerns about vaginal mesh, in a review that will also look at the pregnancy test Primodos, and an epilepsy drug.
[link url="https://www.theguardian.com/science/2018/apr/19/vaginal-mesh-surgery-exposed-women-to-unacceptable-risks"]The Guardian report[/link]