Risks of surgical mesh implants

Mesh implants may be used in a number of surgical procedures to provide additional support when repairing weakened or damaged tissue. Over recent years attention has increased on what are thought to be infrequent but sometimes serious complications that may be associated with the use of this mesh in uro-gynaecological procedures to treat pelvic organ prolapse and urinary incontinence.

These complications have included persistent pain, sexual problems, mesh exposure through vaginal tissues and occasionally injury to nearby organs, such as the bladder or bowel.[1] In 2015, there was an acknowledgement by the NHS England working group that there was a lack of comprehensive data on complications, and work has been ongoing to ensure that patients are encouraged to report complications and clinicians report adverse events.

There have been a number of reviews looking at the use of mesh, both Departments of Health in England and Scotland have undertaken work in this area, as have the MHRA and the European Commission. In August 2017, it was reported that the Welsh Government were setting up a working group to consider the recommendations on the use of mesh implants.

The NHS England oversight group published a final report of a review of the use of mesh implants in July 2017. This stated that the use of mesh to treat women with stress urinary incontinence and pelvic organ prolapse is a safe option, but there is a “need for better information for women experiencing SUI and POP, better data and a multi-disciplinary approach to caring for women.” The report provided information on action in a number of areas:

• Providing information to patients on the procedures and potential complications;
• Updating clinical guidelines for surgeons and GPs;
• Ensuring that data on complications following procedures using mesh are collected and used to inform clinical practice; and

The provision of a number of centres offering appropriate multidisciplinary services for women affected by mesh complications.The most recent Government response on this issue, from the Under-Secretary of State for Health, Jackie Doyle-Price, has set out that there are ongoing discussions between Ministers, the NHS and the Medicines and Healthcare products Regulatory Agency on the support for patients, and continuing work to assess the risks of the mesh implants. However, the Minister also said that these procedures are effective for a number of women, a good review of the evidence was needed to make sure the procedures are used appropriately and that women are aware of the potential risks involved.[2]

Individuals affected by mesh complications have expressed concerns about the safety of the mesh implants themselves, and disappointment that the recent review has not looked at this. It has been reported that a number of UK patients are pursuing legal action against the mesh implant manufacturers and the NHS. There has been legal action on this issue in other countries, where, in a number of cases, manufacturers have been ordered by courts to pay damages to those affected.

Please see Commons Library Briefing Paper Surgical mesh implants for more information.

[1] NHS Choices, Treating a pelvic organ prolapse

[2] HC Deb 10 October 2017 c148