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RCOG/BSUG response to NICE guidance on stress urinary incontinence and pelvic organ prolapse

News 2 April 2019

The National Institute for Health and Care Excellence (NICE) has published its final guidance on the management of stress urinary incontinence and pelvic organ prolapse. 

It recommends that the full range of non-surgical options – including lifestyle interventions, physical therapies and medicines – should be offered to women with these conditions before any surgical operations are explored.  

In addition, NICE has published patient decision aids for stress urinary incontinence, pelvic organ prolapse and uterine prolapse. These are endorsed by NHS England, The Royal College of Obstetricians and Gynaecologists, The British Society for Urogynaecology and The British Association of Urological Surgeons.

In cases where it is agreed to use surgical mesh/tape, the guidance states that women must be fully informed of the risks and offered a follow-up appointment within six months following surgery. It also recommends how complications associated with surgical mesh/tape surgery should be assessed and managed.

The guidance also sets out that any complication should be reported to the Medicines and Healthcare products Regulatory Agency (MHRA) and details collected in a national registry.

The Royal College of Obstetricians and Gynaecologists (RCOG), and The British Society of Urogynaecology (BSUG), said:

“Stress urinary incontinence and pelvic organ prolapse are common and often debilitating conditions for which women must have access to a range of safe and effective treatment options.

“We therefore welcome NICE’s final guidance on the management of these conditions, which recommends that the full range of non-surgical options should be offered to women before any surgical procedures.

“We also fully endorse the patient decision aids published by NICE which are important resources for women and clinicians that will help them to understand all treatments available, as well as the benefits and risks associated with each option. These will support women and clinicians to make an informed choice about the best possible treatment for their individual circumstances.

“At the time of publication of the updated NICE guideline and patient decision aids, it is important to note that the high vigilance restriction remains in place for the use of mesh. While the period of high vigilence continues, healthcare professionals should continue to follow any restrictions.

“The RCOG and BSUG remain firmly committed to meeting the conditions set out by the Independent Medicines and Medical Devices Safety Review to ensure women receive the safest and most effective treatments.”


Note to Editors

For media enquiries, please contact the RCOG press office on 020 7045 6773 or email

A period of high vigilance restriction regarding vaginal mesh is currently in place in England and Scotland. Read the College’s safety alert for more information.

The RCOG mesh webpage brings together a number of resources to help women and healthcare professionals about the use of mesh.