The facts on mesh

Re: “Women beg province to pay for surgical mesh removal,” Nov. 29.

The article presents an unbalanced view of a controversial subject, and misrepresents local and national expertise in this field.

The two most common pelvic floor disorders requiring surgical correction are pelvic organ (vaginal) prolapse, and urinary stress incontinence. The evolution of surgical meshes has facilitated more durable and less invasive approaches. Unfortunately, at their inception, numerous products flooded the marketplace with little regulation and inadequate clinical data. Surgical products and technique had to be refined after the products were already in heavy use and surgeons with inadequate expertise were invited to participate in these repairs. The result was a number of complications. As these came to light, the U.S. Food and Drug Administration held hearings with key stakeholders and issued an advisory in 2008.

When these procedures are performed on properly selected patients using modern products and careful technique, serious complications are rare. Mesh-related complications are extremely rare. This is certainly the case in Calgary, where the vast majority of such operations are performed by fellowship-trained surgeons with high-volume practices in this field.

Complications do occur, as with any surgery, and the rare mesh complications can be devastating. Four Canadian centres, including Calgary, have extensive experience dealing with such complications. While none has treated as many patients as UCLA, it is wrong to imply expertise cannot be found in this country. With or without ultrasound, removing mesh is never simple or without further risk, and cannot be taken lightly.

Dramatic and unbalanced reporting of these can be a disservice to countless women who might benefit from such surgery.