Once a common procedure given to women after childbirth, vaginal mesh implant surgery is now the subject of a public health scandal.
Vaginal mesh first hit headlines in April 2017 after the BBC’s Victoria Derbyshire programme reported more than 800 women would be taking legal action against the makers of the implants.
Now, thousands of women worldwide have reported life-changing complications after having vaginal mesh surgery, with some telling HuffPost UK they have experienced “intense pain” and been forced to give up work.
As a manufacturer was ordered to pay an American woman $100 million in compensation for complications, NICE updated its guidelines on the procedure in the UK, saying mesh should only be used “in the context of research” until further evidence is available.
The Independent Medicines and Medical Devices Safety Review, led by Baroness Cumberlege, is currently underway to investigate how widespread complications are.
So what exactly are vaginal mesh implants and, in light of recent news, should women who currently have them be worried?
What Is A Vaginal Mesh Implant?
A vaginal mesh implant, sometimes referred to as a “sling implant”, is a treatment designed to help women who experience pelvic organ prolapse and incontinence.
Before it hit headlines, the treatment was common in the UK, with more than 92,000 women receiving a vaginal mesh implant between April 2007 and March 2015 in England alone.
According to the NHS, pelvic organ prolapse is the bulging of one or more of the pelvic organs into the vagina. These organs are the uterus, vagina, bowel and bladder.
Although pelvic organ prolapse isn’t life-threatening, it can affect your quality of life by causing problems passing urine, leaking urine when you cough or sneeze, or difficulty having sex.
If other treatments – such as pelvic floor exercises – were unsuccessful in treating symptoms, vaginal mesh implants were previously recommended to support the vaginal wall and/or internal organs.
“A vaginal mesh is purely a synthetic net material used in the placement of a weak connective tissue or ligaments, suspending the vagina and uterus,” consultant gynaecologist and obstetrician Dr Amed Ismail, from Queensway Gynaecology Clinic, told HuffPost UK.
The mesh can be implanted via a simple operation where the vagina is opened at the vaginal wall and the mesh is secured in place.
“This allows the angle between the urethra and the bladder to be a better shape to allow the woman to be continent rather than incontinent,” Dr Ismail said.
Who May Have Received Vaginal Mesh Implants?
Age and childbirth can both lead to weak connective tissue, so women who are mothers and women over 50 may have been prescribed vaginal mesh.
“Usually it’s for women who’ve had several children or, if they’ve only had one child: they’re overweight, have had a vaginal tear or never did any exercise during pregnancy or after having a baby,” Dr Ismail said.
The risk of pelvic floor prolapse and associated incontinence is also increased with being overweight, having a particularly difficult childbirth (such as long labour) and long-term coughing (for example, if you’re asthmatic).
What Are The Complications?
HuffPost UK has spoken to women who report “intense pain” after vaginal mesh surgery, with some left unable to walk long distances, work or have sex.
Joanne Lloyd, who had vaginal mesh inserted in 2004 after the birth of her three children, said: “It felt like glass or razor blades inside me. It was just horrendous.”
Such complications are usually caused by the mesh eroding and breaking down into smaller pieces which potentially move, according to Dr Ismail.
“The vagina area being stitched up is a weak point of the vaginal wall,” he said. “The mesh can find its own way through this weak point and protrude outside the vagina.”
He said women may become aware of erosion if they feel discomfort during sex or if their partner can feel the mesh during sex. Women who experience erosion of vaginal mesh may need to have a second operation in order to have the mesh removed or fixed.
Should Women Be Worried?
The Medicines and Healthcare products Regulatory Agency (MHRA), which regulates medical devices in the UK, said patient safety is its highest priority.
“While we recognise some patients do develop serious complications, we also know many patients gain benefit from surgical mesh implants for what can be extremely debilitating conditions,” it said in a statement in July 2019.
The decision to use any mesh device should be made between the patient and clinician, after discussing all the options and “recognising the benefits and risks in the context of the distressing conditions being treated”, it added.
The MHRA encourages anyone who is aware of a complication associated with vaginal mesh to report it via the Yellow Card scheme, regardless of how long ago the implant was inserted.
If you think you may be experiencing complications after vaginal mesh surgery, speak to your healthcare provider and find more advice here.