Patients harmed by surgical mesh are demanding action
from the Government. Health reporter Eileen Goodwin spoke to a
doctor, a politician, and a patient about the issue.
Prof Don Wilson.
• `Thought I was
going mad' with pain
Patients need to know the risk of surgical mesh before its
use in procedures in which it has been associated with
problems, urogynaecologist Prof Don Wilson says.
There was a place for surgical mesh in vaginal prolapse
patients, but only when a higher risk of complications was
acceptable, Prof Wilson told the Otago Daily Times.
Parliament's health select committee chairman Dr Paul
Hutchison told the ODT the situation highlighted the
need for rigorous testing of medical devices.
Prof Wilson has made a submission to the select committee,
which is examining the problem in response to a petition
presented by mesh sufferers.
He would like to see a national register of mesh implant
usage, and appropriate training and certification of surgeons
who use it.
''It's become apparent ... that the women who have the mesh
put in the vagina, up to 10% - sometimes more - can have
problems with the vagina not covering over.
"And sometimes they get quite a lot of pain and discomfort,
and that's the main reason why some women have had some
serious problems,'' Prof Wilson told the ODT.
Prof Wilson, who is based in both Dunedin and Nelson, said he
used a very small amount of surgical mesh, which was safe and
proven in certain procedures such as incontinence repair.
He has not used it for vaginal prolapse for a few years.
''Because [I was] only doing [surgical mesh prolapse surgery]
very infrequently, I don't think it's appropriate for me to
do it, so I now don't do it.''
Surgeons using the mesh should be performing a high volume of
There seemed to be fewer reports of harm from surgeons highly
experienced in its use.
Part of the problem was a lack of information.
Women who had had recurrent vaginal prolapse might be more
inclined to accept the higher risk associated with surgical
Recent publicity about the problem had created unnecessary
fear in some patients about its use in incontinence surgery
in which it was not associated with a high level of adverse
reactions, Prof Wilson said.
The procedure used a thin strip of mesh for which there was
good long-term evidence of its safety, Prof Wilson stressed.
The problem with surgical mesh in vaginal prolapse surgery
was a lack of long-term evidence to support its use, he said.
Apart from using the women's own tissue, another option was
Derived from pigs, it dissolved into the body after several
There was also a lack of long-term evidence for it, but it
did not appear to be causing the same problems, he said.
Prof Wilson expressed sympathy for the women who have been
harmed by surgical mesh.
Health select committee chairman Dr Hutchison said when
contacted it was important to remember surgical mesh use was
developed to improve previously low success rates in prolapse
and other procedures.
''From what we hear around the world, there has been
significant concern about the use of surgical mesh, and
there's no doubt in my mind that it should only be used when
there is fully informed consent of the pros and cons, and
when specialist urogynaecologists use it.''
The situation highlighted the lack of rigorous testing of
medical devices in comparison with medicine.
Dr Hutchison, a National Party MP and a former gynaecologist
who is retiring at the September election, said it would be
for the next Parliament to decide its response to the
He hoped the committee would issue its recommendations on the
matter before Parliament went into recess before the