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Vaginal mesh surgery only to be used as a last resort

New guidelines say the procedure should only be considered when non-surgical options have failed or are not possible.

The vaginal mesh that was fitted to tens of thousands of women, leading some to suffer pain

The UK’s medical watchdog has recommended that all vaginal mesh surgery should be used as a last resort.

The long awaited draft guidelines from the National Institute for Health and Care Excellence (NICE) signal a significant departure from its previous position which stated that the benefits from vaginal mesh implants outweighed the risks.

The U-turn follows a government suspension on vaginal mesh surgery in July after the prime minister ordered a review into the safety of the controversial device.

In its new guidance, NICE recommends that:

:: Surgical interventions using surgical mesh/tape should only be considered when non-surgical options have failed or are not possible.

:: A national database should be set up to record all procedures involving the use of surgical mesh/tape in operations for stress urinary incontinence or pelvic organ prolapse to help with future decision making.

:: In the cases where it is agreed to use surgical mesh/tape, women must be fully informed of the risks.

Professor Gillian Leng, NICE’s deputy chief executive, said the committee had used the data and evidence from women to reach their conclusions.

She said: “I don’t think this is the end of vaginal mesh but it signals limited use in very specific circumstances.

“If a woman does think this is going to be the right option then that surgery will have to be carried out by a specially trained surgeon in a regional centre, which to date was not happening.”

Sky News special report

The complication rate for vaginal mesh implants, used to treat urinary incontinence in women, is almost 10% – much higher than the officially reported rate of 1-3% – according to figures obtained by Sky News

Sky News first reported on the complications of mesh surgery three years ago. The implant is made out of polypropylene plastic and has been used for decades to treat stress urinary incontinence mainly brought on after childbirth.

It is inserted through the vagina and designed to support the bladder like a sling but once inside the body it can stiffen, erode and cut through organs.

Joanne Lloyd had vaginal mesh surgery in 2004 to treat incontinence brought on after the birth of her three children. She says she wasn’t told of the risks and rather it was a quick fix operation. However, it left her in constant pain.

“I was an active 38 year old before the surgery and used to love walking and being sociable,” the 52-year-old from Warrington said.

“Now my 78 year-old mother is fitter than me. She can play football with my son, I can’t.”

Joanne has had corrective surgery to have the mesh removed but says the damage has been done.

“It has destroyed my health, I’ll never get it back to the way it was. It’s impacted on every part of my life. I have back pain, leg pain, pain all over really.”

Joanne says she only realised her symptoms were caused by her mesh last year when she heard about the campaign group Sling the Mesh and the complications other women were experiencing.

The group was set up by Kath Sansom in 2015 with a few members and now has almost 7,000.

She said: “We’re really delighted that NICE are taking this seriously and setting up a national register. But this is also tinged with sadness because there has been 20 years of harm.

“It’s not over as in my opinion the draft NICE guidelines don’t go far enough.”

Chair of the all-party parliamentary group on Surgical Mesh Implants, Owen Smith, said: “This is a welcome U-turn from NICE, who in their 2016 guidelines for mesh did not recommend any other treatment options for SUI and in fact stated that complications from mesh were ‘infrequent’.

“While I am pleased that NICE is now taking action to advise against mesh as a first-line treatment, this announcement is well overdue. I have called on them to get on and urgently publish these guidelines for the last two years and I’m glad they have finally listened.

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