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Pelvic mesh

SA Pelvic Mesh CONSUMER SUPPORT LINE: 1800 66 MESH (1800 666 374)

Pelvic mesh has been used in the treatment of pelvic organ prolapse and stress urinary incontinence since the ‘90s and the majority of women who have had surgical treatment continue to have a good long-term outcome; however, some women have experienced complications. As a result the State Government has established a contact line for women concerned about the safety of pelvic mesh.

The SA Health Pelvic Mesh Consumer Support Line:

1800 66 MESH (1800 666 374)

9am – 4pm, Monday to Friday (except public holidays)

Pelvic mesh, also known as transvaginal mesh as it is implanted in a surgical procedure via the vagina, is woven synthetic netting usually made from Polypropylene. Other synthetic meshes can be implanted via laparoscopic procedure for intra-abdominal approach.
Pelvic mesh is implanted into the pelvis for a variety of conditions, usually pelvic organ prolapse and stress urinary incontinence.

  • Pelvic organ prolapse - a condition where a woman’s vaginal walls and pelvic organs (uterus, bladder and bowel) lose natural support, which causes them to bulge down within, and sometimes outside of the vagina. Find out more
  • Stress urinary incontinence - a condition where the supporting tissues of the bladder neck and urethra lose their natural support, which causes an accidental loss of urine with physical activity such as coughing, sneezing or exercise. Find out more

These two conditions are different but both may occur in the same woman, and the surgeries for the two conditions may be performed together. The mesh used in each condition is made from the same material, but the nature of the operation for each condition is quite different.
In most cases:

  • The recommended first line treatment for either condition is with a physiotherapist trained in pelvic floor problems, except in severe prolapse as outlined above.
  • Women can safely choose to have no treatment and prefer to manage with pads or other treatment / aids.
  • Treatment is usually only recommended if prolapse or incontinence symptoms are bothersome, or there is an extremely large prolapse creating bladder blockage, kidney blockage, vaginal ulceration or pelvic pain. 
  • Women should consider conservative (non-surgical) treatment before considering surgical treatment.
  • Surgery for both prolapse and stress incontinence generally involve procedures that reinforce the weakened support tissues.
  • Many women choose to go on to surgery because they have not gained sufficient improvement with non-surgical treatments, and the condition is affecting their quality of life.

The majority of women have a good outcome from transvaginal mesh procedures; however, there are women who have suffered complications. Some of these are very serious and life changing, particularly for women who experience severe chronic pain, have had mesh exposure or erosion into the bladder, urethra or bowel, or recurrent vaginal exposure and infection.

In December 2017, the Therapeutic Goods Administration (TGA), Australia's regulatory authority for therapeutic goods, removed transvaginal mesh solely used for the treatment of pelvic organ prolapse (such as bladder, bowel or uterine prolapse).

Transvaginal mesh products can cause significant and severe complications for some women including:

  • Punctures or lacerations of vessels, nerves, structures or organs, including the bladder, urethra or bowel, requiring surgical repair.
  • Mesh extrusion, expulsion or erosion into the vagina or other structures or organs.
  • Acute and/or chronic pain; or neuromuscular problems.
  • Infection.

Symptoms that may be associated with pelvic mesh implant complications include:

  • Pain that is not improving - low abdominal, pelvic, groin, thigh or buttock pain 
  • Poking / prickling sensation or spasms in the pelvic area
  • You or your sexual partner feeling the mesh through the vaginal wall
  • Pain (either you or your sexual partner) during sexual intercourse
  • Abnormal vaginal bleeding or discharge 
  • Difficulty with bladder emptying
  • Pain associated with urination
  • Recurrent bladder infections
  • Abscess or swelling at the mesh insertion or exit sites.

Further assessment and any additional treatment should be undertaken by experienced Urogynaecologists or Urologists who specialise in pelvic surgery.

As part of the process, assessment and treatment options specific to your circumstances should be discussed and tailored to these concerns and problems.

Assessment

The most common assessments are bladder function tests: urodynamics, where a telescope will look inside the bladder or a cystoscopy, where a thin tube with a camera is inserted into the urethra. A specialised ultrasound may be helpful. You and your doctor should decide whether an ultrasound would be helpful; taking into account your circumstances.

Treatment

What can be done to help in these circumstances very much depends on what is found in your assessment, other medical factors and your expectations.

Treatment may include:

  • bladder and/or pain medications
  • expert physiotherapy (particularly for bladder/bowel dysfunction and down regulation of pelvic muscles; standard pelvic floor exercises are not appropriate and may lead to increased pain)
  • pain management strategies
  • psychological support
  • targeted partial removal of mesh (particularly for localised problems, such as a small painless vaginal exposure)
  • full removal of mesh (particularly for chronic pain).

Combinations of these management strategies are often recommended.

When considering mesh removal there needs to be an individualised balance struck between the risk of further complications associated with the mesh remaining, compared with the risk of complications from any removal procedure and also the possibility of complications remaining with the mesh removed.

You may wish to access your medical record from the hospital where you had the surgery. More information is available under ‘How can I make a request for access to my medical records?’

The SA Health Pelvic Mesh Consumer Support Line: 1800 66 MESH
(1800 666 374) can provide more information regarding access to your medical records.

If you are having symptoms visit your GP to determine if the symptoms are associated with a mesh implant. If your GP does not have details of your operation you or your GP may ask for a copy from the hospital via Freedom of Information, to help establish a management plan for you.

The SA Health Pelvic Mesh Consumer Support line: 1800 66 MESH
(1800 666 374), can provide more information regarding access to your medical records.

SA Health has established a governance framework to develop support for women who are ‘mesh affected’. Lead clinicians from across South Australia, along with consumer advisors, are working to develop the best strategies to support ‘mesh affected’ women in South Australia.

SA Health is developing clinical referral pathways and dedicated pelvic mesh clinics with support provided from a multidisciplinary team; including a pain specialist, clinical psychologist, pelvic physiotherapist, urogynaecology specialist nurse, social worker and ultrasound specialist.

As treatment will be individualised not every woman will need to see all members of the multidisciplinary team.

SA Health has introduced a pelvic mesh consumer support telephone line to support women. This telephone support service is operational between 9 am and 4 pm, Monday to Friday (except public holidays).

SA Health Pelvic Mesh Consumer Support Line: 1800 66 MESH
(1800 666 374).

If you are worried or have symptoms that may be related to your pelvic mesh surgery you are encouraged to call the SA Health Pelvic Mesh Consumer Support Telephone Line on 1800 66 MESH (1800 666 374) between
9 am – 4 pm, Monday to Friday (except Public Holidays) to discuss your issues.

If you require help in accessing the Pelvic Mesh Consumer Support Line the following services are available.

For those who speak languages other than English:

  • Translation service: phone (08) 8226 1990,
    then ask for 1800 666 374.

For those who are deaf, hearing impaired or speech impaired:

  • TTY users: 133 677 then ask for 1800 666 374.
  • Speak and Listen users: 1300 555 727 then ask for 1800 666 374.
  • Internet relay users: connect to the National Relay Service then ask for
    1800 666 374.

Patients who have had a pelvic mesh procedure may wish to access their medical record. The South Australian Freedom of Information Act 1991 gives members of the public a legally enforceable right to access information held by the South Australian Government, subject to certain conditions.

The SA Health Pelvic Mesh Consumer Support Service: 1800 66 MESH
(1800 666 374) can provide more information regarding accessing your medical records.

Pelvic mesh, also known as transvaginal mesh as it is implanted in a surgical procedure via the vagina, is a woven synthetic netting usually made from Polypropylene.

There are a wide range of products made from polypropylene that are commonly called mesh that are used in many different types of surgery. The mesh used for these surgeries is essentially the same mesh used by general surgeons to repair hernias and other abdominal wall defects.

If you have any concerns regarding the product that was been used in the surgery that you have undergone, you would benefit from requesting a copy of your Medical Record from the site where the surgery was performed and discussing your concerns with your GP or the treating surgeon to ascertain what, if any, product was used in your surgery/procedure.

If you have any concerns about your upcoming surgical procedure you would benefit from speaking to your doctor / surgeon so that you are fully informed before your procedure and what medical device, if any are planned on being used in your procedure.

Contact the SA Health Pelvic Mesh Consumer Support Line: 1800 66 MESH
(1800 666 374) between 9 am and 4 pm, Monday to Friday (except public holidays) if you require any assistance.

A sling could be one of a wide range of products made from ‘polypropylene’ that are commonly called ‘mesh’. Other terms used for mesh to repair prolapse include tape, ribbon and hammock.

The Therapeutic Goods Administration decided on 28 November, 2017 to remove transvaginal mesh products whose sole use is the treatment of pelvic organ prolapse via transvaginal implantation from the Australian Register of Therapeutic Goods. In Australia at present, ‘mesh’ products such as a ‘sling’ are not restricted in the treatment of stress urinary incontinence.

If you have any concerns regarding a product used in your surgery, you may benefit from requesting a copy of your Medical Record from the hospital site where your surgery was performed. It would be advisable that you discuss your concerns with your GP or the treating surgeon.

The Therapeutic Goods Administration decided on 28 November, 2017 to remove transvaginal mesh products whose sole use is the treatment of pelvic organ prolapse via transvaginal implantation from the Australian Register of Therapeutic Goods.

In Australia at present, ‘mesh’ products such as a ‘sling’ are not restricted in the treatment of stress urinary incontinence.

If you have any concerns regarding a product used in your surgery, you may benefit from requesting a copy of your Medical Record from the hospital site where your surgery was performed. It would be advisable that you discuss your concerns with your GP or the treating surgeon.

The report on the Australian Government Senate Inquiry - Senate Community Affair Reference Committee: Transvaginal Mesh 2018 (PDF 1019KB) recommended that ‘full mesh’ removal should only be undertaken in a urogynaecology unit. South Australia currently does not have a recognised urogynaecology unit and is subsequently not planning to undertake ‘full removal of pelvic mesh’ until this clinical service issue can be addressed.

Generally, the health service provider who creates a medical record owns that record. This doesn't interfere with your right to access your record, because ownership and access rights are separate.

In some cases, an individual may need a representative to assist them in gaining access to their medical record. For instance, an individual may be unable to exercise their access rights because they lack the legal capacity to do so, but their guardian (if they have one) may seek access, if the guardian has the appropriate legal authority.

When making an application for access to your medical records through the Freedom of Information (FOI) process you will need to provide enough information to enable the correct documents to be identified.

SA Health agencies

Each SA Health agency operates separately for the purposes of FOI legislation.

Applications for access to documents must be made in writing and lodged with the agency that holds the document. To apply for access to your personal medical records you can complete the Pelvic Procedure: Freedom of Information Application Form (PDF 342KB) or you can download an FOI form from the website of the site where the surgery was performed.

It is recommended that you read the Pelvic Procedure: Request for Access to Health Records fact sheet (PDF 238KB) before completing and lodging your application.

The SA Health Pelvic Mesh Consumer Support Line: 1800 66 MESH
(1800 666 374) can provide more information regarding accessing your medical records.

N.B. SA Health is supporting women in South Australia who are experiencing complications from pelvic mesh, and is waiving the FOI application fee and the associated charges.

Private health service

Australian Privacy Principle 12 in the Privacy Act deals with access to personal information (including health information). However, it doesn't set out any requirements for the way you should make an access request.

This means you can request access to your medical records simply by asking the health service provider holding the records. If the request is a complex one, for example the information comes from a number of different sources, it may be necessary to provide the request in writing. Your health service provider may need to establish your identity before providing you with access.

If you believe you have been unfairly denied access to your medical record by the ‘private health service’, you can make a complaint to the Office of the Australian Information Commissioner.

Health service providers should respond to a request for access to medical records within an appropriate time. What is appropriate will depend on a number of factors, which can include;

  • the amount of information requested,
  • the complexity of the organisation's functions and activities, and
  • the way the access is to be provided.

A request for access will be dealt with as soon as practicable, or within 30 calendar days of it being received. In certain circumstances the agency may extend the timeframe for dealing with your application and should inform you if an extension is necessary, and why.

Generally, health service providers are required to give you access to your health information.

However, in some situations, health service providers may refuse to give access. For example, health service providers can deny access if they reasonably believe letting a patient see their records would pose a serious threat to the patient's life, health or safety, or the life, health or safety of someone else (such as a relative, the health service provider or their staff).

The threat must be significant, for example where there is a serious risk the patient may cause self-harm or harm to another person if they saw the information.

The threat can be to physical or mental health safety, but does not need to be imminent — it can be a serious threat that could occur sometime after access is granted.

If you believe you have been unfairly denied access to your medical record by an ‘SA Health agency’, for example a public hospital, you have the right to seek an internal review by the Principal Officer/Chief Executive of that agency. If access is still not granted then further rights to request a review exists, either to the Ombudsman, or to the South Australian Civil and Administrative Tribunal.

If you believe you have been unfairly denied access to your medical record by the ‘private health service’, you can make a complaint to the Office of the Australian Information Commissioner.


  • Health Consumers Alliance of SA Inc.
  • Australian Pelvic Mesh Support Groups – Support groups are available on Facebook by searching ‘Australian Pelvic Mesh Support Groups’. A moderator may need to approve you joining the group.

SA Health has established a governance framework to develop support for women who are ‘mesh affected’. Lead clinicians from across South Australia, along with consumer advisors, are working to develop the best strategies to support ‘mesh affected’ women in South Australia.

SA Health is developing clinical referral pathways and dedicated pelvic mesh clinics with support provided from a multidisciplinary team; including a pain specialist, clinical psychologist, pelvic physiotherapist, urogynaecology specialist nurse, social worker and ultrasound specialist.

As treatment will be individualised not every woman will need to see all members of the multidisciplinary team.

SA Health has introduced a pelvic mesh consumer support telephone line to support women.  This telephone support service is operational between
9 am and 4 pm, Monday to Friday (except public holidays).

SA Health Pelvic Mesh Consumer Support Line: 1800 66 MESH
(1800 666 374)

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