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Wyndaele et al. evaluated the trends in female stress urinary incontinence (SUI) surgery in a UK tertiary referral centre during five years before the July 2018 tape suspension and to compare it with NHS England data. They found that when all invasive treatment options are transparently presented to female patients with SUI, they prefer other surgical treatments as an alternative to mid-urethral sling.

There is concern among patients, surgeons and health authorities regarding reported adverse patient outcomes following use of mesh in certain urogynaecological surgical procedures. The European Society of Coloproctology (ESCP) has conducted an extensive review of the surgical literature on the outcome of use of mesh in the pelvis of patients who have undergone bowel surgery and will shortly publish its recommendations. ESCP would like to hear from patients who have had both good and not so good experiences with colorectal surgery using mesh such as operations for rectal prolapse (rectopexy), or operations for advanced rectal cancer/inflammatory bowel disease who had mesh inserted to assist in skin closure of the back passage area. The survey is designed to capture the experience of patients who have had an operation that involved using mesh in the pelvis as a part of a colorectal (bowel) surgical operation. The survey is NOT designed to cover outcomes following urogynaecological operations for prolapse or urinary incontinence. The use of mesh as part of abdominal wall hernia repair is also not included.

Since 2015 Quomodus has developed the digital course 'Diathermy – a practical guide to electrosurgery' for surgeons and other professional users of electrosurgery. The 30-minute course covers the history of electrosurgery, indication and proper use, adverse effects and complications associated with the use of diathermy. The course has been tested and quality assured by health professionals in Scandinavia. The course is flexible, user friendly and applies to all models of diathermy equipment currently on the market.

While COVID-19 has worsened patient waiting times across the NHS, patients with pelvic disorders have long been an under-served population experiencing unacceptable delays in care. Pelvic floor disorders are varied and can be complex, but treatment is available. However, patients, particularly those requiring surgery, can wait years from presentation before receiving the treatment they need.  The report from the Pelvic Floor Society proposes changes in six key areas: Empowering and educating patients and beyond. Making use of technology. Integrating expertise. Looking again at surgical procedures. Making the most of our teams. Considering collaborations. Each area is addressed with its own chapter in the report.

Getting It Right First Time (GIRFT) is designed to improve the quality of care within the NHS by reducing unwarranted variations. By tackling variations in the way services are delivered across the NHS, and by sharing best practice between trusts, GIRFT identifies changes that will help improve care and patient outcomes, as well as delivering efficiencies such as the reduction of unnecessary procedures and cost savings. Urology departments provide 750,000 episodes of care every year in England. This GIRFT report for urology makes 18 recommendations to help improve patient care and increase urology capacity, based on visits to 140 trusts. Key themes include: optimising outpatient services. improving patient experience and reducing length of stay. placing a greater focus on urology emergency care. better networking between urology departments. Following the report, GIRFT published a handbook for urology departments, Getting It Right in Urology handbook: innovations, good practice and guidelines for establishing a urology area network Short video summary of the report

Stress urinary incontinence is when you leak urine accidentally, especially during exercise or when you cough, laugh or sneeze. The National Institute for Health and Care Excellence (NICE) has produced a diagram that shows what treatments NICE recommends as options for managing stress urinary incontinence. If you have tried to manage your condition without surgery, but this hasn’t worked, you might like to think about surgery. This decision aid can help you and your surgeon decide together which type of surgery is best for you. You might also decide that you don’t want to have any surgery. It is important to make the choice that you feel is right for you. This will depend on your individual circumstances and how you feel about each type of surgery. Every woman is different, so this decision aid is only a guide. Information about how this decision aid was produced and the evidence on which it is based is available on the NICE website.

Stress urinary incontinence (SUI) is the loss of urine when coughing, laughing, sneezing or exercising. It is a common and distressing condition, with negative impact on quality of life. If conservative treatment, e.g. pelvic floor muscle training, is not successful, the most successful surgical procedures are mid-urethral mesh tape, colposuspension, autologous fascial sling and urethral bulking agent injections. Between April 2008 to March 2017, procedure data from the UK NHS confirmed that 100,516 patients had a mid-urethral tape procedure, while only 1195 patients had a non-tape SUI procedure. Although the 2013 national guideline from The National Institute for Health and Care Excellence (NICE) recommended that tape and non-tape SUI procedures be offered equally, 84 mesh tape procedures were performed for every 1 non-tape procedure over the 10-year period. Hundreds of patients recently engaged in litigation on the basis of lack of informed consent, particularly in offering alternatives to the mesh tape option. Little is known, however, about how patients choose among different treatment options for SUI and there are no validated patient decision aids (PDAs) in this context. PDAs have been shown to increase patient knowledge, clarity about their own values and accuracy of risk perceptions regarding various management options. Women considering SUI surgery require up-to-date information on all common and available surgical procedures as well as support in their decision-making, tailored to their values and needs. Agur et al. on behalf of the NHS Ayrshire & Arran Continence Multidisciplinary Team designed and developed a novel SUI surgery patient decision aid (SUI-PDA) to help women in making a choice of treatment based on their own individual values. This study reports the development and validation of SUI-PDA as well as the initial evaluation of its usefulness in clinical practice for women considering SUI surgery.

For the fourth year, the Health Quality Council of Alberta (HQCA), in partnership with the Patient and Family Advisory Committee (PFAC), held the Patient Experience Awards programme to recognise and help spread knowledge about initiatives that improve the patient experience in accessing and receiving healthcare services in Alberta, Canada. Applications spanned all corners of the province and came from a wide variety of care settings, and ranged from “elegantly simple” to complex in nature. The initiatives described reflected the diverse healthcare needs of Albertans and were equally diverse in their approach to healthcare improvement. However, they all had one thing in common: A desire to make change and deliver a better patient and family member experience. The following four initiatives were selected to receive the HQCA’s 2019 Patient Experience Awards: NowICU Project, Neonatal Intensive Care Unit (NICU), Misericordia Community Hospital Rapid Access, Patient Focused Biopsy Clinic; Head and Neck Surgery, Pathology; University of Alberta Hospital Edmonton Prostate Interdisciplinary Cancer Clinic (EPICC), Northern Alberta Urology Centre Transitional Pain Service, South Health Campus Take a look at their presentations and find out more about these great initiatives.

Our understanding of race and human genetics has advanced considerably, yet these insights have not led to clear guidelines on the use of race in medicine. The result is ongoing conflict between the latest insights from population genetics and the clinical implementation of race. For example, despite mounting evidence that race is not a reliable proxy for genetic difference, the belief that it is has become embedded, sometimes insidiously, within medical practice. One subtle insertion of race into medicine involves diagnostic algorithms and practice guidelines that adjust or “correct” their outputs on the basis of a patient’s race or ethnicity. Physicians use these algorithms to individualise risk assessment and guide clinical decisions. By embedding race into the basic data and decisions of health care, these algorithms propagate race-based medicine. Many of these race-adjusted algorithms guide decisions in ways that may direct more attention or resources to white patients than to members of racial and ethnic minorities. To illustrate the potential dangers of such practices, Vyas et al. have compiled a partial list of race-adjusted algorithms.

The objective of this investigation was to explore the care of patients who have ureteric stents inserted following a diagnosis of a kidney or ureteric stone. A ureteric stent is a narrow tube that is inserted into the ureter (the tube that connects the kidney to the bladder) to help with urine drainage. The reference event investigated was a woman who suffered an episode of kidney stones which was treated successfully but required the insertion of a ureteric stent. The stent was left in situ (in position) for a longer period than intended and became encrusted – that is, minerals filtered from the bloodstream attached to and built up on the stent. This led to the patient needing a more extensive operation to remove the stent. The findings and conclusions aim to prevent the future occurrence of unplanned delayed removal of stents and improve care for patients across the NHS. Safety recommendations It is recommended that the British Association of Urological Surgeons, in collaboration with other relevant specialties (such as the Royal College of Radiologists and British Transplant Society), develops national standards which support electronic and paperbased systems for stent logging/ tracking. These standards should include guidance on monitoring and human oversight. It is recommended that the British Association of Urological Surgeons works with the Patient Information Forum to review its stent patient information leaflet. This should include accessibility and clinical considerations, especially with regards to side effects and complications, and advice on the action to take should concerns arise. It is recommended that the British Association of Urological Surgeons provides guidance for staff working within the stone care pathway to promote consistent advice to patients as part of discharge planning. It is recommended that the British Association of Urological Surgeons encourages members to include information in discharge letters and other communication sent to GPs and patients regarding patients’ stent status, potential complications and the possibility of a retained stent. Safety observations The NHS Summary Care Records (SCR) system is being developed to allow for specific patient groups to be flagged. It may be beneficial for the British Association of Urological Surgeons to liaise with NHSX should opportunities arise in the future to use SCR to flag patients with ureteric stents to aid communication with primary/urgent care services. The National Institute for Health and Care Excellence (NICE) guidance for the management of urinary tract infections does not include ureteric stents as a cause of urinary symptoms which could mimic a urinary tract infection. It may be beneficial for this potential complication to be considered in the next review of this and other clinical practice guidance.

A decision was taken by the Minister for Health, Robin Swann MLA, to establish a statutory public inquiry following the lookback review of urology patients (January 2019 until May 2020) initiated by the Southern Health and Social Care Trust. These concerns were related to Mr Aidan O’Brien, Consultant Urologist employed within the Southern Trust. Terms of Reference Key documents, the hearings and latest news on the Inquiry can be found on the Urology Services Inquiry website.

This episode of the Business of Healthcare podcast delves into the complex and sensitive topic of the mesh scandal which has impacted countless women's lives. Host Tara Humphrey welcomes Consultant Gynecologist and Urogynecology subspecialist Dr Wael Agur to share his expert insights on the rise and fall of mesh devices in surgical procedures. Wael offers a candid look at the multifaceted issues surrounding patient consent, the role of manufacturers, aggressive marketing strategies, and the ethical dilemmas faced by medical professionals.

Kath Sansom’s surgery changed her life forever – and motived her to lobby for its halt. In 2015, Kath Sansom was the “ridiculously superfit mother of two adult daughters”. She had started to have a few “embarrassing leaks” while exercising, so Sansom did what many women do in her situation: she went to her GP, who referred her for transvaginal tape surgery, in which a small piece of mesh is fitted around the urethra to prevent incontinence. “I assumed it was a bit like a coil,” says Sansom, 54, a PR manager from Cambridgeshire, “and if I didn’t get on with it, I could have it taken out. I had no idea it was permanent.” When Sansom awoke from her surgery, she was in pain, but expected it to settle down. “But the pain got worse,” she recalls. “It frightened me. I have good pain tolerance but I’d never experienced pain like it. I felt so stupid that I’d gone in for surgery and not even Googled it before I did. I trusted my doctor." Sansom started researching and learned that the procedure had been suspended in Scotland since 2014, after concerns over side-effects. “I felt so stupid,” she says, “that I’d gone for surgery and not Googled it beforehand. I trusted my doctor.” She decided to raise awareness of the possible side-effects of the procedure and founded Sling the Mesh in June 2015. Within days she had 20 members; now there are 9,400. Everyone in the group has been devastated by mesh. “Seven out of 10 women have lost their sex lives,” says Sansom. “A quarter are suicidal. The devastation on the page is so awful.” Further blogs from Kath Sansom ‘Mesh removal surgery is a postcode lottery’ - patients harmed by surgical mesh need accessible, consistent treatment Ineffective medical device recalls are a patient safety scandal Regulatory flaws: Women were catastrophically failed in the mesh, Primodos and Sodium Valproate tragedies

CORESS is an independent charity, which aims to promote safety in surgical practice in the NHS and the private sector. CORESS receives confidential incident reports from surgeons and theatre staff. These reports are analysed by the Advisory Board, who make comments and extract lessons to be learned. Aiming to educate, and avoid blame, CORESS calls on surgeons to recognise a near miss or adverse event, react by taking action to stop it happening and then report the incident to CORESS so that the lessons can be published. Every month CORESS highlight's one of the cases reported for you to consider the issues raised and read the experts comments. The focus of CORESS is on detecting and learning from no-harm, near-miss and low harm events encountered during routine surgical practice. The programme collects reports of such events, analyses them and disseminates the learning contained within them to a wide surgical audience and other agencies involved in Patient Safety matters. These events are known collectively as ‘Accident Precursor Events’ or simply ‘Precursors’. See previous reports below. Summer 2021 - Unrecognised limb ischemia following trauma, differences of opinion in management for tongue laceration, lack of communication in patient discharge, consequences of service disruption during the COVID-19 Pandemic, systems and communications errors leading to orthopaedic Never Event, too slick by half. Winter 2020 - Missed pulmonary embolism, gastrectomy kit miscommunication, leaking gastrostomy, fatal pulmonary embolus after renal cancer surgery, ureteric injury, PICC line misplacement, CVP line causing haemothorax. Summer 2020 - Thoracic outlet surgery complications, missed breast tumour in pooled case, abscess confusion, injection error, fall from grace, atypical thromboses.

Surgical mesh is a medical device that is used to provide additional support when repairing weakened or damaged tissue. The majority of surgical mesh devices currently available for use are made from man-made (synthetic) materials or animal tissue. This page on the US Food and Drug Administration (FDA) website outlines the types and uses of surgical mesh and the latest update on mesh manufacturers ordered to stop selling devices for transvaginal repair of pelvic organ prolapse.

In this blog, Luke Yamaguchi describes his experience of hernia mesh surgery and the impact the procedure had on his health. He tells his story of having laparoscopic hernia repair using polypropylene (PP) mesh, which left him with severe chronic pain. After nine years, he underwent mesh removal surgery. Alongside his story, he describes the risks associated with surgical mesh and the use of PP as a material, highlights the lack of research about its side-effects and draws attention to the role of industry in promoting the use of mesh.

A monthly journal for all operating theatre staff covering surgical and anaesthesia news. 2024 February issue The post-anaesthetic care of a patient following impacted wisdom tooth extraction New Inquiry: NHS Leadership, Performance and Patient Safety Pensioner goes home within hours of having heart valve replacement surgery A student’s Reflection on an experience within the obstetrics theatre Multidisciplinary clinical hub at Cardiff Met offers new vision for healthcare delivery January issue The change in practice of aortic procedures following the introduction of hybrid theatre in a tertiary centre. Evolving heart surgery education is crucial to equip surgeons with the skills to match the technology. A case study detailing the postoperative recovery of an elective patient. Why managing NHS waiting lists is about safety, not just numbers. Keeping an eye on bad behaviour in the operating theatre. Reducing oxygen levels for children in intensive care will save lives, new study shows. Navigating burnout in healthcare: A critical examination of operating theatre staff in the UK. 2023 December issue Royal Papworth patient is first recruit to new ‘blood powder’ heart surgery research trial. A simple guide to the Patient Safety Incident Response Framework (PSIRF). The post-anaesthesia care of an elective inguinal hernia repair patient. Surgical teams at Southmead Hospital carry out 24 robotic-assisted gynaecology procedures in two days. New deep learning challenge to estimate breast density from mammograms. Retained swabs following invasive procedures: Themes identified from a review of NHS serious incident reports. November 2023 Workplace ostracism is clearly associated with healthcare workers’ job satisfaction, stress and perceived health. London operating department practitioner advocacy pilot project. How to share decision-making about major surgery for people at high risk of complications. Proportion of people from Black, Asian and minority ethnic communities registering to donate on the NHS Organ Donor Register is on the rise Trends in cancer. The world’s first collection of brain metastasis living samples will help treat each patient with the most effective therapy for them. Children’s Surgery Magic October 2023 A reflection on my learning as an individual and as part of a team during my second-year anaesthetic placement. Region-wide AI deal to help tackle waiting lists across nine NHS trusts. North Tees and Hartlepool NHS Trust uses RealWear headsets for training. Patients treated sooner thanks to Joint Working to Improve Orthopaedic Care. “Embracing Sustainability in the Operating Theatre: The Shift to Reusable Scrub Caps”. September issue Serious hazards of transfusion (SHOT) report warns of alarming increase in transfusion errors and harm to patients. Doctors cut waiting list for breast cancer surgery patients. Study reveals surgeons need to improve how they communicate with patients about new procedures. Professor Sir Terence Stephenson, "all NHS trusts must use barcodes to locate high-risk devices". Nurses’ intentions to quit increased during the pandemic despite their high resilience. August issue Most common medical claims: How to avoid malpractice allegations. Report recommends packaging and labelling change to prevent implant ‘never event’. New guidance on safe injection practice in hospitals emphasises the importance of prefilled and labelled syringes in avoiding medication errors. Progress with the new hospital programme. Advancements in minimally invasive surgery: Techniques, instruments, and patient outcomes. July issue NHS must accept accountability and learn from mistakes. Simulation based education in healthcare higher education: In what ways does it impact perceived clinical confidence, knowledge, and skills acquisition in student Operating Department Practitioners? Risk reduction in endo-tracheal tube fixation. Historic plan launched to move Wales towards zero deaths from bowel cancer. Taking higher-than-recommended doses of Vitamin D for five years reduced the risk of atrial fibrillation. As complications from cosmetic tourism rise, UK and Turkish plastic surgeons unite to issue consumer guidelines. New research highlights opportunities to improve care of patients having major surgery. June issue How to THRIVE in the Operating Theatre Preoperative optimisation: The effect of prehabilitation interventions on the postoperative recovery of cancer patients undergoing colorectal surgery – Literature review and discussion based paper. Surgeons must tackle three global health challenges to save lives. “PERUSE before you Infuse”. Artificial Intelligence could speed up heart attack diagnosis, SurgiBox: Ukraine’s SurgiBox Project has been successfully demonstrating safe surgery to patients around the world May issue Reducing mortality in emergency surgery: Focussing minds through a national clinical audit in the NHS. Majority of NHS trusts do not offer training to prevent sexual harassment, study finds. Handwashing during ‘normal times’ can reduce burden of respiratory disease. The Surgical Education Checklist as a tool to improve teaching within the operating theatre. April issue NatSSIPs 2 Sequential Steps: The NatSSIPs Eight – Flowchart. Mobile operating theatre helping drive down waiting times in Yorkshire. Why hospitals and ICBs are seeking new intel to find hidden high-risk patients on waiting lists. March issues NHS Scotland first in world to ‘clean up’ anaesthetic gases. New standards to Improve the safety of invasive procedures in the NHS. Researchers suggest novel cutpoints for diagnosing cardiac hypertrophy in adolescents and young adults. NHS patients targeted to reduce risks as they wait for hospital treatment. February New standards to improve the safety of invasive procedures in the NHS. Delphi Study Round Three – A study across NHS England hospital trust operating theatres. Crash and burn(out) – Aviation-style safety checklist and confidential helpline for surgical community to prevent mental health crisis. A Wound Care Study: has the pandemic led to new and improved ways of working? HSIB investigation: Access to critical patient information at the bedside. Artificial intelligence, Patient safety and achieving the quintuple aim in anaesthesiology. January Delphi Study Round Two – A study across NHS England hospital trust operating theatres. Intercollegiate green theatre checklist Local Interventions to support the recovery of elective surgery at the University College London Hospitals department of theatres & anaesthesia. 2022 December issue Delphi Study Round One – A study across NHS England Hospital Trust operating theatres. Managing NHS backlogs and waiting times in England. Steroid injections worsen knee arthritis, according to two new studies. First robotic hysterectomy completed in Wales. World’s first algae-based local anaesthetic another step closer to reality. How new bacterial species siscovered in Asian soil could help battle against antibiotic resistance November issue New research calls for all health and care staff to be trained in AI Reducing noise in operating theatre improves children’s behaviour after surgery, study finds Brain tumour patient operated on awake while playing saxophone No difference between spinal versus general anaesthesia in patients having hip fracture surgery finds study October issue Why are intra-operative surgical Never Events still occurring in NHS operating theatres? Radical rethink needed to improve safety in health and social care. World Anaesthesia Day 2022: History, significance, celebrations and theme. £4 million “space-age” operating theatre will help bring down eye surgery backlog. Two thirds of nurses choosing between food and fuel as cost of living bites and one in five turn to food banks. ‘An inspirational story’: Hartlepool cleaner changes career to become hospital nurse. September issue Service evaluation of the current World Health Organisation’s Surgical Safety Checklist in spine surgery at the University Hospitals of Derby & Burton. Could this lead to a change in NHS Improvement? The Anaesthetic Gas Scavenging System Project. Cancelled operations could be prevented by an earlier anaemia test and time to prepare. The top 10 things experts need you to know about screening during Gynaecological Cancer Awareness Month September 2022 £35.5m for New Friarage Hospital Operating Theatres. New robotic surgical system revolutionises patient care at UHCW. Insourcing: Giving NHS operating theatre teams a helping hand. Arterial stiffness raises blood pressure in adolescents via insulin resistance. Birmingham’s Public Health Chief is among sector leaders to receive university honours,

This report by the US non-profit organisation the Emergency Care Research Institute (ECRI) was commissioned by the US Food and Drug Administration (FDA) to determine the safety profile of polypropylene (PP) mesh used in a variety of surgical procedures. ECRI performed a comprehensive literature search and systematic review to identify the current state of knowledge about how patients' bodies respond to PP mesh. Key findings Local host responses to polypropylene (PP) used in surgical mesh included pain, foreign body sensation, seroma and haematoma. When PP mesh was used in other surgeries (female stress urinary incontinence mesh or mini-sling, transvaginal or transabdominal prolapse mesh), the primary local responses were erosion/exposure followed by dyspareunia and pain. Studies reported these complications from immediately post surgery to five years post surgery. Evidence suggested that lightweight PP mesh was less likely than heavier weight PP mesh to cause pain or foreign body sensation. There were no studies elucidating patient– or material-related factors contributing to systemic responses. ECRI’s data pointed to infection in 40% of event reports associated with PP mesh. There were five deaths, and when patient harm was reported, 44% required intervention or hospitalisation. Evidence gaps The report identifies the following evidence gaps: Studies of local and systemic host response to PP as a material. Studies examining local or systemic host response to diaphragmatic hernia mesh. Better quality evidence regarding local responses such as inflammation, mesh migration, and pain and regarding systemic responses to mesh such as allergy, autoantibody development and systemic inflammation.

Do you suffer from bladder leakage on coughing or exercising? Are you considering surgery because pelvic floor exercises and other options did not work? Learn what happens during the four main surgical procedures, how surgery works and what are the main advantages and disadvantages? This video will help you choose the bladder surgery most suitable for you. For further information, visit https://www.yourpelvicfloor.org/leafllets of the International Urogynecology Association (IUGA).