Vaginal mesh must be offered as a last resort, according to health authorities | Society

Health officials said that vaginal mesh should be offered to patients.

A draft guidelines from the National Institute of Health and Care (Nice) indicates that women with stress urinary incontinence or pelvic organ prolapse, conditions that typically manifest themselves after childbirth, should instead be offered a range of non-surgical treatments, such as lifestyle interventions, physical therapies and medications.

Surgical interventions using mesh should be considered when non-surgical options have failed or are impossible, said Nice.

A recent scandal about vaginal mesh procedures revealed that thousands of women have complained of constant pain after implant placement. A Guardian investigation found that one in 15 women who received a mesh implant required surgery to remove it, some with potentially life-changing complications.

In July, the government suspended the use of certain vaginal mesh procedures in NHS hospitals in England until certain conditions were met, including that all possible operations and complications be recorded in a national database and that surgeries be performed by specialist surgeons based on specialists. centers.

The draft Nice Guidelines calls for the creation of a national database to record all procedures involving the use of surgical stitches and ribbons in operations for urinary stress incontinence or pelvic organ prolapse. When the surgical mesh is proposed in treatment, the women must be fully informed of the risks, said Nice.

Sir Andrew Dillon, General Manager of Nice, said: "Where a mesh / surgical tape might be an option, there is almost always another intervention recommended in our guide … If a surgeon can not provide a full range of choices to the patient, then should be referred to whoever can. "

Commenting on the draft guidelines, Kath Sansom, founder of the Sling the Mesh campaign group, said: "These draft guidelines should be welcomed but do not go far enough. Our ideal scenario is to see the pelvic mesh stopped – complete stop. The risks are too great. It is totally unacceptable for women to come out of a "small operation" with broken lives. "

Carl Heneghan, professor of evidence-based medicine at Oxford University, who had previously called for a public inquiry into the use of the net, said: "We have been far too quick to resorting to surgery as a first choice while she should have been a Heneghan called the guidelines "not in the right direction".

In a joint statement, the Royal College of Obstetricians and Gynecologists and the British Society of Urogynaecology said, "It is very important that women explore the range of non-surgical treatments, such as lifestyle interventions, physical therapies and drugs, before considering surgical treatments. . It is also crucial that women who need surgery for these often painful and debilitating conditions have access to these treatments. "

Owen Smith, chair of the multi-party MSG group on mesh surgical implants, said, "While I am happy that Nice is acting now to discourage mesh as a front-line treatment, this announcement is long overdue. I have asked them to continue to urgently publish these guidelines for the past two years and I am happy that they have finally listened. "