Study warns against mesh implants as first-line treatment for some conditions

Mesh implants should not be recommended as a first-line treatment for certain conditions, according to a new study.

The procedure can be used to treat women suffering from prolapse and bladder problems but an independent review was ordered in 2014 after women who had been left suffering from painful complications took their case to Holyrood.

A new study published in The Lancet on Wednesday found that current evidence supports the use of mesh procedures for incontinence and for prolapse of the top of the vagina.

However, mesh procedures for prolapse involving the bladder or bowel were less effective than non-mesh operations and much more likely to lead to longer-term complications.

The study was carried out by the NHS Information Services Division (ISD), which was asked to undertake an independent analysis of the outcomes following mesh and non-mesh operations carried out in Scotland. ISD public health medicine consultant Dr Rachael Wood, who led the study, said: "Some mesh procedures are likely to be relatively safe and effective for some patients.

"Having said that, the results of this study show that mesh procedures should not be recommended as first-line treatment for prolapse of the bladder or bowel.

"Women considering mesh surgery, or concerned about complications, should speak to their GP or surgeon in the first instance.''

In June 2014, the then health secretary Alex Neil asked health boards to suspend the use of the implants after a campaign by women who have suffered serious side effects.

On Tuesday MSPs heard that around 400 mesh implant operations have been carried out since ministers called for them to be suspended.

The figure was quoted by Labour MSP Neil Findlay, who told the Scottish Parliament of the "devastating life-changing consequences'' experienced by some women who have had the procedure.

For the study published in The Lancet, ISD worked with colleagues from various universities, looking at hospital discharge records for women undergoing operations for incontinence and prolapse, which is where the bladder, womb or bowel pushes down into the vagina causing discomfort.

They were able to analyse their post-surgery outcomes and examine the safety and effectiveness of mesh surgery for incontinence and prolapse.

Dr Wood said: "Stress urinary incontinence and pelvic organ prolapse are common conditions affecting many women and substantially reducing their quality of life.

"It is important that safe and effective treatments can be offered to women affected by incontinence and prolapse.

"We hope that our study will help women who are contemplating treatment to make a more informed decision.''

Health Secretary Shona Robison on Tuesday said the Scottish Government has no authority to withdraw the products and confirmed that a review on the issue will be published early next year.

Speaking on Tuesday, she said: "The request to suspend procedures will remain until the independent review's recommendations have been put in place.

"In light of the Scottish Government's request, the number of women receiving mesh implants has fallen.

"However, if women are experiencing very distressing symptoms and still want to proceed then I would want to give my reassurance that prior to a decision to have the mesh implant, all clinicians are expected to have a detailed discussion with their patients with the risks explored and explained so that a shared decision can be made and fully informed consent taken.''

• Scottish News