Kath Sansom of the United Kingdom launched Sling The Mesh as a support group for women suffering pelvic mesh pain and complications. It began with 20 women in 2015 and has now become an important patient-advocacy group with more than 6,600 members from around the world, including a growing number of men and women with hernia mesh complications.
Mesh implants are made of plastic material which can change once implanted. They can shrink, go brittle, and twist. Fragments can fall off during insertion or after implantation. This is what is causing catastrophic and life-changing injuries for patients who are mostly ignored or misunderstood when they present to doctors or surgeons, many of whom do not understand the impact of mesh-implant pain.
The saddest part of this story is that if independent national registries were used in every country, this catastrophe would have been detected much earlier. It would have saved thousands of people from needless suffering caused by an operation sold as a simple, minimally-invasive, quick fix.
An independent registry means every single patient would be logged and tracked for their lifetime. I am told this would add around an extra £20 to a person’s treatment cost; a small price to pay for robust patient safety.
There are now national registries in the U.K. for metal hips and breast implants following scandals involving their use. However, that is a classic case of shutting the gate after the horse has bolted. Registries need to be brought in as standard for all new medical devices so that trends can be picked up immediately and investigated accordingly.
Instead, in the mesh implant disaster, we see a catalogue of 20 years of harm. In those two decades, surgeons have lost the old-fashioned skills needed to perform pelvic floor or hernia repairs using a person’s own tissue. What a sad place we are in that new surgeon trainees mainly only know how to use mesh and older surgeons have fallen out of practice of a safer type of surgery.
Here in the U.K., Sling The Mesh is pushing for a total overhaul of surgeon training programmes for newcomers. We know of training courses hastily teaching old-school repairs without mesh. This must happen globally, because if traditional skills are lost, they are gone forever. The result would be catastrophic.
In December 2017, Canadian patient Chrissy Brajcic, 42, died of sepsis after she became antibiotic-resistant from a four-year battle against urinary tract infections caused by her TVT mesh to fix mild incontinence after having babies. In the end, no antibiotic worked and every time she got a new infection she would go to the hospital for strong medication to be fed via a drip. Eventually even that failed.
Sling the Mesh ran a survey of 540 women which shows more than half suffer constant UTIs and one in 12 women are becoming antibiotic-resistant, so they are at risk of sepsis.
In August, Scottish patient Eileen Baxter, 75, died from a prolapse mesh implant – the type surgeons insist is safe, as it was inserted abdominally instead of vaginally. She suffered sepsis, multiple organ failure, rectal perforation, and chronic inflammation of her pelvis. Her son told The Scotsman newspaper that Eileen tried to explain to medics she was in pain but was sent for counseling to teach her how to handle it better.
The Medicines and Healthcare Products Regulatory Agency in the U.K. lists 11 mesh-related deaths, and on the TVT Worldwide registry it lists three deaths from the TVT Secur alone, a particular model of mesh to fix incontinence, now not in use.
In the U.K. there is currently a suspension of mesh implants to treat stress urinary incontinence until April 2019, while an independent safety review is carried out by senior Tory peer, Baroness Julia Cumberlege. New National Institute for Health and Care Excellence guidelines are due out in the same month which will outline recommendations for mesh implant use for incontinence and prolapse and analyze if benefits do not outweigh the risks.
We at Sling the Mesh know the benefits do not outweigh the risks to public safety, and now call for the device to be banned in the U.K.. We are urging for the suspension to become a total ban once the independent review chaired by Baroness Cumberlege is completed. We are asking that a full investigation and audit be carried out as to how many women have been affected by vaginal mesh and tapes. We are calling for a mandatory independent National Register for all new medical devices, so patients can be tracked for their lifetime, and adverse events and trends be picked up immediately. There is a long road ahead, and we will continue to offer support to the thousands of patients around the world that have been affected by this crisis.