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 most 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, explosion or erosion into the vagina or other structures or organs.
- Acute and/or chronic pain; or neuromuscular problems.
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.
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.
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.
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.
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.
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 telephone service: 1800 66 MESH (1800 666 374) can provide more information regarding accessing your medical records.
- 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.