Mesh ‘Last Option’ for Incontinence


New draft guidelines for the NHS advise that women who need treatment for urinary incontinence should only be offered mesh surgery as a last resort.

The National Institute for Health and Care Excellence (NICE) says non-surgical options, like pelvic, muscle exercises, are the first to turn to.

Sir Andrew Dillon, chief executive of Nice, said “Where surgical mesh/tape could be an option, there is almost always another intervention recommended in our guideline, which does not involve surgical mesh/tape. If a surgeon cannot provide a full range of choices to the patient, then she should be referred to on who can.”

This isn’t the first time the risks of vaginal mesh operations have been highlighted in the news. There have been several press reports highlighting how women have been seriously affected by the implants. Many have suffered from issues including serious pain, inability to walk, work, or be intimate with their partners.  Others claim that they were not warned of the possible complications.

NHS England had already announced restrictions on mesh operations following safety concerns following a review looking at harm reported by women who received the treatment for stress urinary incontinence.

The review’s chair, Baroness Julia Cumberlage said she was “appalled at the seriousness and scale of the tragic stories” that her team has heard. “We strongly believe that mesh should not be used to treat women with stress urinary incontinence until we can manage the risks of complications much more effectively. We have not seen evidence on the benefits of mesh that outweighs the severity of human suffering caused by mesh complication”

“My team and I are in no doubt that this pause is necessary. We must stop exposing women to the risk of life-changing and life threatening injuries. We must have measures in place to mitigate the risk, and those are sadly lacking at the moment”.

In the spring 2017, the Victoria Derbyshire programme also broke the news that more than 800 women were taking legal action against the NHS and the makers of vaginal mesh implants.

Although the implants have been used successfully in many other parts of the body, they appear to be reacting differently when inserted in the abdomen, leading to some women being cut.

Between 2006 and 2016, more than 11,000 women in England were given vaginal mesh implants according to NHS data. However, on average 1 in 11 women suffered from complications.

In December 2016, a study published in the medical journal, The Lancet, found that women who were given mesh implants were approximately three times more likely to suffer complications and twice as likely to require follow-up surgery compared to women who underwent the more traditional surgical procedure, where stitches are used to help support the organs.

The Medicines and Healthcare products Regulatory Agency (MHRA) continues to defend the use of mesh implants and states that “for the majority of women, the use of vaginal mesh implants is safe and effective”. However, data from the MHRA indicated that between 2012 to 2017 there were 703 adverse incidents for patients who had been given the implant to treat stress urinary incontinence. A further 346 adverse incidents were reported for patients who had been given a mesh support to prevent pelvic organ prolapse.

It is impossible to avoid all mistakes, and it should be noted that there is an element of risk in all surgical procedures but ongoing investment and research is essential to ensure continuous improvement and prevent the complications faced by many women.

If you or a member of your family has been affected by any of the issues raised in this article, you can seek independent legal advice from our clinical negligence specialists.


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