Transvaginal mesh implants

In recent years there has been some growing concerns about the use of transvaginal mesh implants, which are used for the treatment of pelvic organ prolapse (POP) or stress urinary incontinence (SUI).

Following the public petition in Scottish Government about concerns raised with complications related to use of transvaginal mesh for both POP and SUI, the Scottish Government completed an independent review. This looked into the safety, use and efficacy (effectiveness) of transvaginal implants.

The report which was published in March 2017 made recommendations around managing patient who are considering surgery for SUi and POP and those suspected of having mesh related complications.

Some of the conclusions made by the independent review include:

• Shared decision making with health professionals and patient choice is essential when choosing treatments
• In the case of surgical treatment for stress urinary incontinence, individuals must be offered all appropriate treatments (mesh and non-mesh) as well as the information to make treatment option choices about their treatment
• In the surgical treatment of pelvic organ prolapse, current evidence does not show any extra benefit from the use of transvaginal implants (prolypropylene mesh or biological graft) over native tissue repair. Transvaginal mesh procedures must not be offered routinely

Further resources

• NICE Guidelines: Urinary incontinence and pelvic organ prolapse in women
• BSUG: Vaginal mesh tape procedure for treatment of stress urinary incontinence
• NICE: Patient decision aid
• Royal College of Obstetricians and Gynaecologists
• Scottish Government News: Halt in use of transvaginal mesh