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RCOG statement in response to NHS mesh review

News 17 April 2018

NHS Digital has published a review of patients who have had a urogynaecological procedure for prolapse or stress urinary incontinence including those where mesh, or tape or their equivalents were used.

Between 2008 and 2016, a total of 100,516 patients had a reported tape insertion procedure for stress urinary incontinence and 27,016 patients had a reported mesh insertion procedure for prolapse.

In 2016, there were 7,245 patients who had an insertion for tape insertion procedure, a reduction of 48% from 2009 when 13,990 patients were recorded. Meanwhile, there were 2,680 patients in 2017 who had a reported mesh insertion procedure for prolapse, a reduction of 13% from 2008 when 3,073 patients were recorded.

Professor Linda Cardozo, spokesperson for the Royal College of Obstetricians and Gynaecologists (RCOG), said:

“We welcome this retrospective review which provides some insight into the number of women who have undergone surgical procedures for the management of pelvic organ prolapse and stress urinary incontinence, including operations in which mesh or tape was utilised. However, the data contained within the report provide only a ‘snap shot’ from which it is difficult to extrapolate any clear conclusions relating to the number and severity of surgical complications. 

“The results of this report confirm findings from other published studies which show that mesh and tape removal has decreased significantly over the last decade, with less than 2% of patients requiring mesh or tape removal. These figures therefore provide support for the use of mesh in carefully selected patients.  Unfortunately, retrospective data collection cannot inform us why patients underwent subsequent surgical procedures, including mesh removal. 

“The report also highlights a clear decline in the number of women who have undergone urogynacological surgery between 2008 and 2017. It is impossible for the review to show why this decrease has occurred - it may be because of alternative therapeutic interventions or better prevention.

“Women with urinary incontinence or pelvic organ prolapse must be made aware of all the treatment options available and empowered with the information they need in order to make informed choices appropriate to their lifestyle. It is important that all women who experience complications relating to mesh devices are referred via their GP to a specialist unit with a multi-disciplinary team of professionals who can listen, advise and support them.

“The RCOG and The British Society of Urogynaecology (BSUG) continue to call for mandatory prospective data collection through the BSUG database, a well-established method of collecting outcome data for all urogynaecological procedures, including mesh. This would give more accurate information regarding outcomes, including both success and complication rates, and provide comprehensive data to inform women and healthcare professionals about the benefits and risks of all urogynaecological procedures.”

ENDS

Note to Editors

For media enquiries, please contact the RCOG press office on +44 (0)20 7045 6773 / pressoffice@rcog.org.uk

RCOG mesh webpage with resources to help support decision-making by women and healthcare professionals. 

About the RCOG
The Royal College of Obstetricians and Gynaecologists is a medical charity that champions the provision of high quality women’s healthcare in the UK and beyond. It is dedicated to encouraging the study and advancing the science and practice of obstetrics and gynaecology. It does this through postgraduate medical education and training and the publication of clinical guidelines and reports on aspects of the specialty and service provision. https://www.rcog.org.uk/