Gynaecologists voice concern over surgical mesh in women causing harm

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There's concern doctors may have leapt in too quickly to use surgical mesh on women patients without waiting for proof it was safe.

Jeannie McEwan is in chronic pain, which started in 2003 after she was treated with a transvaginal surgical mesh.
Source: 1 NEWS

That's the claim from some of the country's leading gynaecologists in the wake of a Health Select Committee report suggesting changes to reduce the harm caused to hundreds of patients through mesh use.

Transvaginal mesh has been in use worldwide since 2001, largely to surgically treat common prolapse and stress urinary incontinence issues in women.

But 27 clinical studies worldwide now show one in 12 patients go on to suffer complications, including having the mesh erode into other organs causing chronic pain.

An FDA alert in 2011 saw eight types of transvaginal mesh banned and there are now multiple international class action cases underway against mesh manufacturers.

ACC figures released to ONE News show over 500 patients have had claims accepted for mesh injury in the past decade with more than $10 million paid out for treatment and compensation.

Wellington gynaecological surgeon Dr Hanifa Koya has treated dozens of women in recent years, attempting to surgically remove embedded transvaginal mesh.

She says 50 of her patients have endured up to 10 procedures each to try and have it all removed.

"These people live in chronic pain thereafter and I never expected I would be dealing with people in so much agony," she says.

Greymouth grandmother Jeanne McEwan is one such patient.

She has been in constant chronic pain since having transvaginal mesh used to treat her prolapse problem in 2003.

Source: Close Up

"I havn't felt the same since it first went in and felt very sick and tired almost immediately," she says.

Ms McEwan, who is facing her seventh operation next month, says her Christchurch surgeon at the time reassured her the mesh was safe.

"I just feel like I was a total guinea pig," she says.

Auckland University Professor of Gynaecology Cynthia Farquhar says she now feels doctors worldwide raced to use transvaginal mesh back when it was new, before waiting for enough proof it was safe.

"There's no doubt in my mind we embraced it too quickly without waiting to see what the clinical trials were showing," she says.

The first international clinical trial results suggesting harm only started appearing from 2003 onwards.

Both Professor Farquhar and Dr Koya support recommendations just released from the Health Select Committee to more carefully monitor surgical mesh use in New Zealand.

The recommendations came after two Auckland patients, Carmel Berry and Charlotte Korte, took a petition to parliament seeking an inquiry into all mesh, including mesh used for non-gynaecological procedures such as hernia repair.

The recommendations include having the government investigate setting up a national mesh registry to track mesh use and complication rates and also consider expanding Medsafe's role in assessing the quality and safety of all new medical devices.

Medsafe says its own investigations have concluded that surgical mesh is safe when used in accordance with the manufacturer's instructions by an appropriately-trained surgeon. It notes mesh remains approved by medical device regulators globally.

But Dr Koya believes transvaginal mesh for women patients should be banned.

"I do not use these products and it is my belief that all transvaginal meshes should be taken away," she says.

Professor Farquhar says it still has its uses in some patients.

"There is a place for it, probably not as a first line treatment but for women who are having second or third operations for prolapse," she says.

All agree, the risks must be fully communicated to all patients before surgery so women can make an informed decision.

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