Vaginal mesh ban ‘a retrograde step’

Image caption The mesh is made of a type of plastic and surgeons routinely use it in hernia repairs

Banning vaginal mesh implants would remove an important treatment for some women suffering from a prolapse, says the Royal College of Obstetricians and Gynaecologists.

Some women benefit from the implants and should have a choice, it said.

The health watchdog NICE is expected to recommend that the implants be banned.

Around 800 women are taking legal action against the NHS and mesh manufacturers, saying they have suffered from painful complications.

When a prolapse occurs, doctors sometimes insert a mesh into the wall of the vagina to act as scaffolding to support organs – such as the uterus, bowel and bladder – which have fallen out of place.

Hundreds of women have reported problems with this plastic mesh, which is made of polypropylene.

Image caption Prof Linda Cordozo says banning vaginal mesh is not a good idea

However another smaller device made from the same material, called a tape, which is used to stem the flow of urine from a leaking bladder, has a much lower risk of complications.

Prof Linda Cardozo, a surgeon at King’s College Hospital in London, said there was a misconception that all types of mesh were a problem.

She explained that she was not in favour of banning the use of mesh for prolapses.

“I don’t think a total ban on anything is a good idea. It stifles the opportunity to offer the minority something that might benefit them,” she said.

Draft guidelines from NICE say the implants should only be used for research – and not routine operations.

But Prof Cardozo said that a ban would stop any further research as well.

“If mesh is banned, there will be no more clinical trials,” said the professor.

“Banning it is a retrograde step – we will go back to how we were a century ago when we couldn’t offer women a range of options.”

Creating anxiety

Prof Cardozo pointed out that artificial hips and knees were not perfect when they were first introduced, but thanks to further research and progress they ended up improving lives.

“We need to be very careful that [mesh] is used in the right women by the right doctors… who have explained the risk-benefit ratio and all other types of treatment,” she added.

Some doctors did not have the skills or training to put in vaginal meshes, and the devices have been overused, the professor has argued.

She also said the debate over vaginal mesh was making some women who had had surgery unnecessarily anxious.

“They are panicking because they believe something terrible may be happening inside their body as a result of tape or mesh, but most women are problem-free,” said Prof Cardozo.

Image caption Kathryn Taylor says her mesh implant has improved her life

Kathryn Taylor was just 35 when she suffered her first prolapse.

She was later diagnosed with a condition that had weakened the muscles around her uterus and bowel.

Last year she had a second vaginal mesh implant to help keep those organs in place.

“Mesh isn’t right for everyone, but it’s totally changed my life for the better,” Kathryn said.

“Without it I wouldn’t be able to work and lead a normal life.

“I’d have to have a colostomy bag attached to my leg,” she explained.

Image caption Stephanie Williams is waiting to have her mesh implant removed after being left in constant pain

However campaigners, like Stephanie Williams, are protesting against all types of vaginal mesh and tape.

They are calling for more research and say women have not been given the full facts about the possible side effects.

In her own case, Stephanie says she didn’t realise she was having a vaginal mesh implant and it has left her in constant pain.

“The word mesh was never mentioned,” she said.

“I would not have even known what mesh meant at the time and if it was mentioned beforehand we would have looked into it before,” she added.

She is now waiting to have her mesh removed.

Addressing concerns

John Wilkinson, the director of devices at the Medicines and Healthcare products Regulatory Agency (MHRA) said: “Patient safety is our highest priority and we recognise some women do develop serious complications which can be very significant for the affected women.”

“We also know many women gain benefit from these surgical procedures for what can be extremely debilitating conditions,” he added.

Mr Wilkinson encouraged patients and doctors to report any complications linked with the mesh implants through the Yellow Card scheme.

The NHS has always insisted that the vast majority of procedures using mesh are a success and many women have benefitted from surgery.

The health watchdog – the National Institute for Health and Care Excellence (NICE) – is due to make its final recommendations next week.

Companies in the US have already paid out hundreds of millions of dollars in compensation to patients.

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Read more: http://www.bbc.co.uk/news/health-42280544