Mesh probe offers NZ a blueprint
A Kiwi woman who spent $40,000 to have a United States surgeon remove her surgical mesh says New Zealand should follow new recommendations out of an Australian Senate inquiry.
Renate Schutte, 50, was implanted with a TVT-O midurethral sling in a procedure to treat stress urinary incontinence (SUI) in 2012. She developed severe burning pain in her groin and down her legs last August.
When Missouri surgeon Dr Dionysios Veronikis removed it, that groin pain disappeared ‘‘almost instantaneously’’.
Schutte considered herself fortunate to be able to pay for the treatment.
‘‘There are so many people who can’t do that, they haven’t got any ACC cover, they have no private insurance and they are falling through the gaps, they’ve got nothing.’’
Schutte followed the progress of the Australian Senate inquiry into transvaginal mesh implants since it started in February last year – its report was released this week.
She said the recommendations were ‘‘fantastic’’ and urged the New Zealand Government to consider them seriously.
‘‘The Australians have basically done the work for us. The evidence is there, it’s irrefutable; they just need to carry on and do it.’’
The report made 13 recommendations, including mandatory reporting of adverse events, a medical devices registry, improved informed consent processes, and that implantation only be used as a last resort.
Senators heard harrowing tales from women at hearings in Sydney, Canberra, Perth and Melbourne and received more than 500 written submissions.
Women shared stories of debilitating pain, physical limitations, financial and emotional stress after surgery for stress urinary incontinence (SUI) or pelvic organ prolapse (POP).
One submitter, Joanne, said she could not sit down for longer than 15 minutes at a time and described the pain as being ‘‘a deep, burning, searing ache that intensified with movement.’’
Submissions also came from women with positive mesh surgery experiences, and from doctors and medical colleges supporting its use.
The committee acknowledged the successful outcomes many women experienced but reprimanded those who used this to downplay the few who suffered extreme adverse events.
Instead, the inquiry wanted a ‘‘greater focus ... on understanding why some women experience positive life-changing outcomes and others experience catastrophe.’’
Of about 150,000 Australian women implanted with a mesh device, an unknown number experienced complications as there was no single source of information the committee found.
Under-reporting of adverse events was concerning and led to a recommendation to make it mandatory for medical practitioners.
Senior New Zealand members of the UroGynaecological Society of Australasia (UGSA) supported the senate committee’s recommendations but were concerned about its statement that all mesh devices should be used as a last resort.
Limiting use of the mid-urethral sling, which had a good safety record for SUI treatment, would be a backward step for the one in three New Zealand women who suffered from incontinence as it would force doctors to ‘‘revert to more traditional, riskier surgical methods’’, they said.