Thousands could have been spared mesh complications – review
Thousands of women could have been spared complications from mesh surgery, a damning new review has concluded.
Women told the review team of “excruciating chronic pain feeling like razors inside their body, damage to organs, the loss of mobility and sex life and depression and suicidal thoughts”.
A number of mesh-injured women said their doctors, surgeons or GPs “ignored or dismissed” their concerns.
“Some clinicians’ reactions ranged from ‘it’s all in your head’ to ‘these are women’s issues’ or ‘it’s that time of life’,” the report states.
“For the women concerned this was tantamount to a complete denial of their concerns and being written off by a system that was supposed to care.”
The review says that women have also raised concerns about “missing or altered medical records”.
And many women said they were told the treatment was a “new gold standard”.
The treatment has been used in the pelvis for 20 years, but the review said that its “long-term risk profile” is still unknown.
The Independent Medicines and Medical Devices Safety Review was so concerned by tales of suffering of women who had been fitted with mesh, that it recommended a pause in mesh procedures for stress urinary incontinence in 2018 – meaning procedures should only carried out under exceptional circumstances.
“The review was formed to address the concerns raised by women, but surely others could and should have listened and taken action before,” the report states.
It says that in 2003, guidance on mesh for stress urinary incontinence recommended only experienced surgeons should operate and an audit of numbers of procedures, outcome measures and adverse events should be kept.
“These themes are also reflected in the published literature on pelvic mesh,” the report states.
“None of this happened consistently. There were no checks on implementation of the guidance nor enforcement and no consequences for not following it.
“Had it been implemented, it is likely that many hundreds, perhaps thousands, of women would have been spared mesh complications.”
The review team have made a series of recommendations – including that pelvic floor education should be taught in schools, and antenatal classes.
An “apology is due”, and support is required for those who have suffered avoidable harm, the review added.
But it stopped short of recommending an outright ban.
The review details how women were not always told about the risks of mesh before their procedures and how some women who have faced life-changing consequences only had ‘relatively minor’ stress urinary incontinence at the time.
“The complications that followed have reduced so many to a shadow of their former selves, taking a terrible toll on partnerships and family life,” the report states.
The review team said they were “appalled” to discover the number of women who were not made aware they were being fitted with mesh.
There is not a proper record of just how many women have been treated for stress urinary incontinence and the repair of pelvic organ prolapse using polypropylene mesh.
There is also not a system which has recorded side effects which include: loss of sex life, chronic pain, infection, difficulty voiding, recurrent urinary incontinence, permanent nerve damage or damage to surrounding organs, haemorrhage, autoimmune disease and psychiatric injury.
These complications in turn have led to relationship and family breakdown, loss of employment, loss of a home or financial hardship, the report adds.
“We met so many women with limited mobility having to rely on a wheelchair or crutches to move around, unable to sit for periods at a time, unable to play with their children or carry their grandchildren, living daily with the consequences of the operations and procedures they thought would cure them,” the report states.
“The effects of these procedures have caused fractured relationships for some and placed some women and their families in dire financial straits. In short, the system does not know the true long-term complication rate for pelvic mesh procedures.”
Mesh inserts are intended to become permanently embedded into the surrounding tissue, making removal complex.
“Common sense dictates that if an implantable device is known to be difficult, perhaps impossible, to remove, then it should only be used where there is a pressing medical need that could not be met by conservative treatment. Sadly, this approach has not always been applied to pelvic mesh surgery,” the review adds.
Commenting on the review, Kath Sansom, founder of the campaign group Sling The Mesh, said: “The report is hard hitting and recognises the total failure in patient safety, regulation and oversight in the UK.
“It also makes it very clear that our medical establishment is deeply entrenched in institutional denial and misogyny.
“While we welcome all of the recommendations, there is no glory in knowing thousands of women have been maimed by mesh since the late 1990s then ignored when they asked for help suffering debilitating, life altering and irreversible pain.”
MP Emma Hardy, who has campaigned for women affected by mesh complications, said: “After many years campaigning and many years of pain, their voices are now finally heard.
“This battle was an uphill one that faced constant dismissal of repeated appeals from many women suffering appalling pain and the mishandling of complaints. However, the repercussions and effects of surgical mesh implants will for many be with them for the rest of their life.”
In a statement, Thompsons Solicitors, which is representing 400 people whose lives have been affected by mesh, said: “Our clients have faced rejection and belittlement, while wracked with pain. An apology is long overdue. What those who have suffered for so long deserve is decisive action that leads to real change, starting today.”