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  • ‘Mesh removal surgery is a postcode lottery’ - patients harmed by surgical mesh need accessible, consistent treatment

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    Summary

    In this opinion piece, Kath Sansom, founder of the Sling the Mesh campaign, highlights the many issues that women face when trying to get pelvic mesh slings surgically removed. She calls for the NHS to give patients a voice and to develop a robust and consistent plan to tackle the issues faced by patients harmed by surgical mesh.

    Content

    In Spring 2021, I was due to meet a senior NHS official, along with a group of pelvic mesh campaigners, to ask for consistent training of all surgeons performing mesh removal procedures. That meeting was cancelled, and I’m calling for it to be reinstated, and fast.

    We desperately need action to sort out the inadequate, piecemeal approach the NHS has taken to redress the harm caused by surgical mesh.

    I manage a Facebook support group of over 9,200 women, most of whom are still living with debilitating pain and side effects caused by pelvic mesh. Each experience tells of harm added to harm - of mesh removal surgery being hard to access and inconsistent, and of hopelessly long waiting lists.

    Mesh specialist centres - inconsistent and inaccessible

    There are seven mesh complication centres in the UK[1] - six in England, one in Scotland and none in Wales or Northern Ireland - but assessment and surgical procedures vary hugely between these centres:

    • There is no consistent training for surgeons undertaking mesh removal, with each centre taking its own approach. This needs to be addressed urgently with centralised training and standards to ensure that the most effective, evidence-based approach is taken for each and every woman.
    • Some surgeons seem reluctant to undertake mesh removal and many women are sent away with no treatment other than to ‘keep taking painkillers’. It shouldn’t be that the care a patient is offered depends on a surgeon’s preference.
    • There are only seven mesh specialist centres, meaning some women have to travel hundreds of miles for every appointment. Many have to undergo surgery without a family member or friend with them because of travel costs. In addition, there is only one centre in the country, in London, that will consider removing rectopexy mesh. This mesh may have been implanted in a smaller number of patients, but the incidence and severity of harm seems to be even greater than for women with transvaginal mesh.
    • When patients are offered mesh removal surgery, waiting times are often in excess of two years. As with many other areas of the healthcare system, the problem has been worsened by the Covid-19 pandemic.

    Emerging victims of the surgical mesh scandal

    The Cumberlege Review began to shed some light on the harm caused to women who had pelvic mesh implanted. But the story is so much bigger than pelvic mesh - new patients who have had mesh implanted in other areas of the body are increasingly approaching Sling the Mesh, reporting pain and other side effects. There has been no review in England into the use of mesh to treat hernias[2], and we are seeing an increasing number of women reporting complications after mesh has been inserted into the abdomen following TRAM flap surgery[3], a procedure where abdominal tissue is used in breast reconstruction.

    Many of these people report being told by their surgeons that their pain is caused by ‘anxiety’; much the same story women with transvaginal mesh complications were given six years ago before the media started covering this issue extensively. This amounts to medical gaslighting and adds to the harm caused by the initial insertion of mesh devices.

    The NHS needs to learn from the hard lessons of the pelvic mesh scandal and take a joined-up and patient-centred approach to dealing with these emerging issues.

    The NHS needs to listen and take action

    Baroness Cumberlege’s review should have marked a sea change in the treatment of women who have suffered harm as a result of transvaginal mesh. But the NHS response has lacked will and focus, leaving thousands of patients still living with pain and distress as a result of surgical harm. 

    Those individuals and agencies with the power to bring consistency and compassion to mesh removal surgery need to listen to the patients who have suffered life-changing injury. And taking the time to meet with us would be a good first step.

    Suggested reading

    Regulatory flaws: Women were catastrophically failed in the mesh, Primodos and Sodium Valproate tragedies - a blog by Kath Sansom

    Ineffective medical device recalls are a patient safety scandal - a blog by Kath Sansom

    A year on from the Cumberlege Review: Initial reflections on the Government’s response (Patient Safety Learning, 23 July 2021)

    Transvaginal Mesh Timeline (7 December 2017)

    References

    1. 'England Mesh Complication Centres Announced'. British Society of Urogynaecology website, 5 February 2021
    2. 'Hernia mesh complications "affect more than 100,000"'. BBC website, accessed 22 November 2021
    3. 'Breast reconstruction using tissue from your tummy'. Macmillan Cancer Support website, accessed 22 November 2021

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