Long-term rate of mesh sling removal following midurethral mesh sling insertion among women with stress urinary incontinence (2018)

Summary

We often hear the mesh scandal blamed on poor surgeon skill. We also hear the argument that high use mesh implanting surgeons are likely to have fewer patients suffering mesh complications, than a less experienced surgeon.

However, this study published in JAMA in October 2018, based on NHS data, shows that high mesh implanting surgeons produce the same or even more mesh complications compared to low volume implanters.

Content

Surgeons could insert 20 mesh implants or 120 and yet the risk / complication rate remains the same.

Some healthcare professionals believe that better training is the answer. Others think that only allowing mesh insertion at a few specialist centres with expert, experienced surgeons, will reduce complications.

But this study from Gurol-Urganci et al. shows this is not the case.

Additionally, the “experienced surgeon” argument does not take into account the properties of implanting polypropylene mesh into patients which include:

• The ticking time bomb quality of mesh which means problems may not start until months or many years down the line – regardless of the skill of a surgeon’s initial placement.
• The mesh material can trigger a host of illnesses including autoimmune diseases, allergies, ibs, fibromyalgia, nerve damage months or years later.
• The mesh material can fragment, twist, degrade, shrink.
• The mesh implanting hooks can cause injuries for up to 40% of patients. For this reason the FDA in America reclassified the hooks up to Class II from Class I in 2016 to allow for special controls.
• Mesh slings for incontinence are inserted blindly and no amount of training can compensate for a surgery where you cant see what you are doing with women whose pelvic tilts differ.

Read Sling the Mesh's blog on the research paper