We must ban the mesh for good
Mesh implants were hailed as a cure for post-natal incontinence. But for thousands of women the results have been catastrophic. Now, furious victims are insisting the operation must go...
PROFESSOR Sue Black is understandably bitter. Her peronal and professional life has been devastastingly affected by complications from a ‘simple’ operation she’d had more than 15 years earlier.
‘I’ve been completely debilitated by a procedure which would never have been used if the patients were men,’ says Professor Black, one of Europe’s most eminent mathematicians and computer scientists.
It’s been a shattering blow to a woman who is no stranger to adversity, having lost her mum at 12 and left school at 16 with few qualifications.
The scandal is that she’s one of thousands of women who have suffered as a result of the same operation: using a type of surgical mesh known as tension-free vaginal tape (TVT) to treat incontinence and prolapse.
Up to 40 per cent of mothers experience these problems post-childbirth. TVT was introduced more than 20 years ago as an alternative to more complicated (and costly) repair surgery: the TVT procedure costs less than €1,000 and is carried out as a day case compared with three nights in hospital for the traditional approach.
While the mesh has been problem-free for some — shockingly, we don’t know the true numbers of those who have had the surgery, because there is no official count — but thousands have been left permanently injured after the hard plastic material disintegrated inside them, slicing into the soft tissue it was designed to hold in place.
In many cases, the implanted mesh have become embedded deep into the woman’s reproductive organs, causing chronic infection, excruciating pain and nerve damage.
Some have been left unable to work or even walk and are now in wheelchairs. The mesh has also destroyed sexual function, causing marriages to fail.
In one tragic case, Canadian Chrissie Brajcic, 42, died from sepsis as a result of antibiotic resistance brought on by repeated efforts to treat infections caused by the mesh.
Reports to the US Food and Drug Administration, which regulates drugs and medical devices, indicated up to half of women who’d received the mesh had some kind of complication.
FOR YEARS, those affected were often dismissed, told by medics that their symptoms were ‘in the mind’.
At the start of this month, a long awaited report into the issues with mesh implants called for an apology to those who have suffered due the implants and a mandatory register of all mesh operations and details of any woman undergoing it, although insiders have been told this could take three years to set up and it won’t be retrospective.
Although the mesh has been banned elsewhere, including Australia and New Zealand, here regulators have only agreed to a ‘pause’ in its use.
The pause in 2018 was put in place by the then Health Minister Simon Harris for the management of stress urinary incontinence or pelvic organ prolapse in HSEfinded hospitals.
‘There is understandable public and patient anxiety about the ongoing safety of mesh devices following the considerable publicity that this issue has received and this has been heightened by recent developments in the NHS,’ he said in 2018. ‘It is important that this be addressed as comprehensively as possible.’ Procedures were paused until recommendations relating to surgical training, informed consent and the development of an agreed dataset of mesh procedures. ‘A pause on the use of mesh procedures, pending confirmation by the Executive that the key recommendations below have been implemented, is now considered proportionate and necessary to provide public assurance that these procedures are being carried out in accordance with internationally accepted good practice.’ Mr Harris said.
But now, due to the register, Britain is lifting the pause there, which means the procedure could still be offered if a register is put in place and there are fears that Ireland could follow.
While welcoming the setting up of specialist removal centres, as well as a central register, British campaigners are dismayed that the failure to ban the mesh has only awarded them a partial victory.
‘I’m extremely disappointed as I wanted to put all this behind me. Although it will be difficult for surgeons to offer the mesh because there’s no register, I think we will have to keep our campaign going because there will be surgeons itching to start using it again,’ said
Kath Sansom, who set up the pressure group Sling The Mesh (which has 8,000 members) after her own problems with it.
She had the mesh implanted in March 2015 to correct mild incontinence following the birth of her two daughters (13 and 18 years before) and, like so many others, she suffered problems.
Although she got the mesh removed after just six months, the damage was done. ‘I was in pain as soon as I woke up from the anaesthetic,’ she says. ‘I used to do high board diving, mountain biking and ran my own photography business. I’ve had to give up those things and I will probably need regular specialist physiotherapy for the rest of my life because of the pain,’ says the journalist, 52.
Annette Powers, 58, a former occupational therapist, has suffered similar damage and thinks the mesh should be banned. The mother-oftwo struggles to walk for more than a few hundred yards after having the mesh inserted in 2002. After 16 years of chronic and painful infections, she had some of the mesh removed, but the stabbing pains have returned.
‘The infection has obviously come back,’ she says in despair.
As for Professor Sue Black, she remains concerned about safeguards for medical treatment for women.
Over the course of this paper’s nine-year campaign for the mesh victims, we have spoken to around 100 women whose lives have been ruined by TVT about the humiliation and intimate agony implanted mesh has caused.
Until recently, Professor Black, 58, was embarking on a political career and among her proposals was a plan to establish a women’s health research centre and address poor regulation of medical devices. Now she has fallen victim to the very problems she was intending to highlight.
‘I’m normally energetic, but I’m just not strong enough to do this at the moment. I normally walk a lot and go swimming and I can’t do any of that, never mind campaign for mayor,’ she says.
‘One of the reasons why this has gone on for so long is that we have a blind faith in the medical profession and the last thing anyone wants to talk about is their vagina or incontinence. The industry has relied on that fact to keep all this quiet.
‘I didn’t want to talk about any of this either, but reading all the stories of these injured women, I felt I have to.
‘I’ve had a relatively lucky escape: the advice women have been given, the nature of the advertising of the mesh (that it was risk-free), and the stories of doctors offering only counselling for extreme pain, telling families their mum’s making everything up or is mentally ill, is truly shocking.
‘This procedure has been quite barbaric and the fact it’s been happening for 20 years or more is even worse,’ says Professor Black.
Her own problems started after the birth of her youngest daughter in February 2004. ‘Straightaway, I knew something felt wrong. I’d had stress incontinence before, but it was manageable until then.’
Her GP sent her for physio, but then she was referred to a gynaecologist.
‘He said my options were the oldfashioned three-hour pelvic repair operation using my own tissues, which he said meant I would have to stay in hospital for several days and take several weeks off work, or there was a new “gold standard” operation, where I would be in and out in a day.
‘He explained it as a tape and showed me diagrams. What I didn’t know then, but know now, is that the surgeon has to guess where to put it. That is why they so often put it in the wrong places.’
She had the surgery in 2005 at the age of 42. ‘I was fine after. I was fit, I did park runs and went to the gym. I was delighted as the operation cured the incontinence.’
However, Professor Black, who is married to Dr Paul Boca, 51, an IT consultant, found the relief was temporary.
‘By 50, I started going into menopause and I thought the symptoms were to do with that. I also developed tiny raised hard purple lumps on my body.’
THE MESH — a foreign material inserted in the body — can cause allergic reactions as the immune system tries to reject it.
‘My face started to get puffy and I found I could only pee if I sat on one side,’ she says.
‘About two years ago, my sister read an article about mesh and said it could be the problem, but my GP said she didn’t think it had anything to do with it.’
After insisting on further investigations, Professor Black eventually had most of the mesh removed in August 2018 by a specialist, thanks to her husband’s private health insurance. It was impossible to remove all of it, because it was embedded.
‘After that, the lumps went within a week, my face didn’t look puffy and I could pee normally.’
She knew more surgery would be necessary to remove the rest of the mesh, but was not banking on a further operation to remove scar tissue caused by the 2018 procedure. This second, hour-long procedure took place in 2019.
‘The day afterwards I fainted in hospital and lost blood because of post-operative bleeding. That led to me becoming anaemic and getting a series of infections.’
After six courses of antibiotics, she is still facing a third major operation which will involve two months off work. ‘It’s all fairly traumatising,’ she says.
Explaining her decision to speak out, she says: ‘If this mesh thing had happened 20 years ago, I would have been too shy to talk about it in public, but you get more confident with age.
‘We need better safeguards for medical treatment on women, including mesh.’