CONTROVERSIAL mesh implants will no longer be routinely offered to women with pelvic organ prolapse, and reporting of all procedures and adverse events involving the implants will be compulsory. However a report into their use has stopped short of recommending an outright ban.
The findings of the Scottish Government's independent review into the safety of transvaginal mesh implants follows accusations that the final report would be a "whitewash". Two patient representatives and one expert consultant resigned from the review group after it emerged that an entire chapter of the final report had been removed.
Tracey Gillies, who chaired the review, said completion of the final report had been "marred by suggestions that evidence has been destroyed or is missing", but stressed that she was "confident that is not so".
She added: "The material presented by one group member and not included in the final report is available on the website with the Declarations of Interest from group members."
The review was launched in 2014 amid concerns over patients suffering painful and disabling complications following surgery with the mesh products to treat stress urinary incontinence or to repair pelvic organ prolapse - a condition which can occur when abdominal muscles are weakened during childbirth. At that time around 1,850 women were undergoing the procedure in Scotland every year, but the report said it was "not possible to provide accurate data" on how many patients experienced complications. While some women had suffered "life changing complications" it was "also evident that many women have benefitted", said the report.
However, it concluded that mesh procedures "must not be offered routinely" to women with prolapse as the "current evidence does not indicate any additional benefit" over tissue repair. Meanwhile, patients with stress incontinence "must be offered all appropriate treatments", including mesh and non-mesh.
The report also recommends that the reporting of all mesh procedures and adverse events must be mandatory, and calls for more research into mesh safety, clearer guidance for patients and improved training for clinicians.
Labour MSP and chair of Holyrood's Health and Sport Committee, Neil Findlay, said the report was an "establishment stitch up". He added: “Essential information has been omitted, reports overlooked and data hidden to ensure the review presents what I suspect was a predetermined position from day one in favour of continuing to implant mesh which has caused so many women long term, life changing damage to their health."
Dr Catherine Calderwood, Scotland’s Chief Medical Officer, said she accepted the conclusions. She said:
“This is a highly complex and technical subject area and they had a wide range of evidence to consider.”
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