TVT mesh: the biggest health scandal of our time?
TVT mesh – or tension-free vaginal tape – is a net-like implant created to fix pelvic organ prolapse and urinary incontinence, typically following hysterectomy, menopause and childbirth. During a relatively simple 20-minute surgery, the mesh is inserted through the vagina or the abdomen and sits below the bladder like a sling.
Popular surgery
It was first used by the NHS in 1996 and quickly became the most popular surgery for stress incontinence, performed on around 13,500 women a year.
A doctor interviewed by Sky News recently described the now controversial medical procedure as one of the biggest health scandals of our time, up there with unapproved silicone gel breast implants and metal on metal hip implants, both of which have been proven to leak into the bloodstream.
Consultant gynaecologist Dr Wael Agur, who made the comments, admitted he once favoured the use of mesh in surgery but, having heard the evidence, has since changed his mind. TVT tape is now known to have a catastrophic design fault.
'Cheese wire' effect
Following surgery, thousands of women have experienced what is known as a 'cheese wire effect', whereby small sharp fragments of the mesh break off and cut into surrounding tissue and nerves.
Not surprisingly, women suffering the resulting internal lacerations are left in terrible pain, forced to take strong painkillers long-term, unable to work, walk freely and some are even restricted to a wheelchair. Although surgery is available to remove the mesh, only a few surgeons will perform it because of the associated risks.
Discrepancy over numbers
The Sky News report highlights a discrepancy between anecdotal evidence from campaigners trying to the get the surgery banned and official government figures. Some figures report 471 women had their mesh implants either totally or partially removed between 2015 and 2016, whereas for the same year, the MHRA (the Medicines and Healthcare products Regulatory Agency) says there were only 171 adverse incidents reported.
Consultant urogynaecologist Dr Sohier Elneil, one of only a few qualified surgeons in the country who can remove the mesh implant, says she's seen a huge increase in patients, from about five women a week to more like 15.
"NICE has revised its guidelines and made them more robust but I still feel many women are getting the procedure done without the full information about the risks," she said.
Cover up
Women suffering the after effects of TVT Mesh are now campaigning to have the surgery to insert the mesh banned. They also claim there has been a cover up by the MHRA, which, they say, has attempted to divert attention away from properly recording adverse incidents.
The procedure was halted in Scotland in 2014, but reinstated in March 2017 amid claims an independent review was a whitewash.
According to Sky, Owen Smith MP is backing calls to suspend the procedure in England until more is known about the risks.
One the risks of this surgery become clear, it looks very likely we will see a large number of medical negligence claims brought by women suffering the horrendous, debilitating after-effects of something that was meant to improve their lives, not make it substantially worse.