Risky vaginal mesh operations should be the last resort, say health bosses – but campaigners are furious as they stop short of a complete ban
- NICE declared two years ago the implants should be outlawed for prolapse
- But the Government body has backtracked on its decision in new guidelines
- Furious victims of the procedure have slammed the announcement today
- The updated guidelines have been branded an ‘institutional betrayal of women’
Mesh surgery should only be used as a last resort – with women having to opt-in after being informed of the risks, according to new official guidelines today.
The advice, from the National Institute for Health and Care Excellence (Nice), recognises there is ‘public concern about mesh procedures’.
Currently, there are restrictions on the controversial procedure, which is used for stress urinary incontinence and pelvic organ prolapse.
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NICE declared two years ago the implants should be outlawed for prolapse – a common childbirth issue that causes the organs to fall out of place
Thousands of women have been maimed by the controversial implants globally, left on the brink of suicide, unable to work and reliant on wheelchairs
Nice said these will remain in place until all operations and complications are registered on a national database. After that, only expert surgeons based at specialist centres will carry out operations for the common disorders – usually stemming from natural childbirths.
The new guidelines have been drawn up by the NHS standards watchdog following a long-running campaign by the Daily Mail’s Good Health team. It highlighted how thousands of women have suffered constant pain, nerve damage and ruined sex lives as a result of the plastic mesh breaking up and migrating to other parts of the body.
Last year, the Government suspended use of vaginal mesh pending an ongoing review.
In a series of recommendations, NICE today said women should only be offered the procedure if non-surgical interventions are either rejected or fail.
Where it is agreed to use surgical mesh or tape, women must be informed of the risks which could include dyspareunia – painful sexual intercourse – pain and other problems.
Last night, the Royal College of Obstetricians and Gynaecologists (RCOG), and The British Society of Urogynaecology (BSUG), welcomed the guidelines. But furious campaigners said the measures have not gone far enough and that the procedure should be banned.
Kath Sansom, of Sling The Mesh, said failure to do so was ‘clearing the way for the next generation of women to be harmed’. ‘It’s Groundhog Day. They [NICE] are ignoring the elephant on the kitchen table.
‘And they have opened the floodgates for thousands of women, including our daughters and granddaughters, to be maimed by mesh in future.’
NHS data shows more than 100,000 patients have undergone a mesh procedure for incontinence or prolapse in the past decade, after its introduction as a cheaper alternative to pelvic repair operations involving the patient’s own tissue.
If implanted near the vagina or bowel, experts say it can set up an infection which may degrade the material. This causes it to break up and fragments can burrow into tissue.
Studies have suggested anything between 10 and 40 per cent of patients have suffered damage. While not issuing a blanket ban, the guidance states women should first consider the range of non-surgical options.
For urinary incontinence, these include lifestyle interventions such as caffeine reduction, modifying fluid intake and weight loss; physical therapies, such as pelvic floor muscle training; behavioural therapies, such as bladder training programmes; or medication.
Those suffering with pelvic organ prolapse can ease symptoms by losing weight, pelvic floor muscle training and pessary management.
If women decide on surgery, any complications should be investigated by consultants.
Women considering surgery should use new patient guides to help determine options. Complications related to the device should be reported, with details put in a national database. Dr Paul Chrisp, from Nice, said: ‘[The guidelines] will ensure each woman is able to decide which option is best.’
Experts say medical devices are poorly regulated. A Department of Health and Social Care spokesman said: ‘Nice’s new guidelines will help women make more informed choices.’