Make mesh implants last resort says Welsh NHS report

An expert group asked to recommend how the Welsh NHS should respond to cases of women left in chronic pain from vaginal mesh operations has called for a totally new approach, avoiding surgery whenever possible. It suggests that the operation became routine, at one time performed on 1,000 Welsh women a year, because for too long no-one spoke up -or was listened to- about the disastrous possible side effects.

Unusually for a medical report, it begins with a quote from the civil rights campaigner Martin Luther King, "our lives begin to end the day we become silent about things that matter”. It highlights what the report's authors heard when women did speak out about what had happened to them.

The surgery was carried out to treat urinary incontinence, vaginal prolapse and birth related injuries. The report accepts that women satisfied with a good outcome of their synthetic mesh operation have not been have heard and "might represent the vast majority". However, it does list a series of what it calls "adverse experiences".

  • Not being informed correctly of the potential risks involved or the potential side effects and how severe and life changing these could be.

  • Not being warned of the potential devastating, life changing complications that could be experienced.

  • An inadequate consent process with one patient reporting that ‘the only written information provided was the manufacturer’s leaflet’.

  • A surgeons denying that pain due to the transvaginal tape he had inserted.

  • ”Medical staff disregarding a mesh complication as post operative symptoms, and not initially attributing symptoms to mesh and insisting on looking for other causes.

  • Women being made to feel like they were ‘making a fuss’, when it later became evident that their symptoms were due to mesh.

  • Consultants being patronising of their ill and vulnerable patients, often reducing them to tears.’

Instead of surgery, the report recommends what it calls a "pelvic health and wellbeing care pathway" designed to avoid wherever possible an operation which is still performed on nearly 200 Welsh women a year. It would aim to offer better continence care, physiotherapy and pain management.