What is transvaginal mesh?
Polypropylene pelvic mesh implants have been used worldwide to treat stress incontinence, a condition that can lead to women leaking from their bladder when doing impact activities such as running and jumping, or when sneezing or coughing.
The condition is very common in women after childbirth and at the menopause.
They were also used to treat pelvic organ prolapse, which affects up to half of all women who give birth and occurs when occurs when a pelvic organ – such as the bladder, rectum or uterus – “sags” and moves out of place.
The mesh is a net-like implant that comes in a number of forms including mesh or tape.
The most common form of implant, called a transvaginal tape (or TVT), has been widely used to treat stress incontinence across Europe, the US and Australia since the early 2000s.
Many surgeons saw advantages over traditional open-surgery procedures, which took longer to perform, involved a longer recovery for patients and were associated with their own range of complications.
What went wrong?
As the mesh became more widely used, women came forward suffering complications and class actions have been brought against manufacturers around the world.
Women reported vaginal scarring, fistula formation, painful sex, and pelvic, back and leg pains.
The mesh implants are designed to be permanent so full removal can require hours of surgery and doctors have to also weigh up the risk of damage to nerves and nearby organs, including the bladder and bowel.
What action did the Scottish Government take?
Scotland's health boards were told to "immediately halt" the use of transvaginal implants altogether in surgery in 2018 following the death of Eileen Baxter, 75.
Multiple organ failure was said to have led to Mrs Baxter’s death, with sacrocolopexy mesh repair – an implant to fix a pelvic organ prolapse – noted as an underlying cause.
In 2014, Alex Neil, the then Health Secretary commissioned an indendent review to look into complication rates and "under-reporting" of adverse events.
The review was published in 2017 but was widely criticised over a range of concerns including the independence of processes.
A subsequent report highlighted failings and recommended another review was carried out.
The Transvaginal Mesh Case Record Review was commissioned in 2021 and today's report records its findings.
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