Patient advocate Sally Walker, who was badly injured in a botched operation, petitioned Parliament to halt mesh operations. Photo / Jason Oxenham
Patient advocate Sally Walker, who was badly injured in a botched operation, petitioned Parliament to halt mesh operations. Photo / Jason Oxenham
A temporary pause on pelvic mesh operations is likely to be in place for at least another year, the Ministry of Health has indicated.
The suspension of mesh surgeries for stress urinary incontinence (SUI) last August was initially projected to last up to 12 monthsbut most of the conditions for lifting it have not been met.
The extraordinary step, which followed similar moves in the United Kingdom, was taken because of safety concerns around the use of mesh for treating SUI, a common childbirth injury.
Ministry of Health chief medical officer Dr Joe Bourne told the Herald progress was being made in implementing safeguards but it was unlikely the halt on mesh operations would be lifted before mid-2025.
“It would be wrong of me to say this is the date that all the actions will be completed, because there is some uncertainty, but we’ve certainly made a lot of progress and I’ll be looking to get a report back as we move into the end of the first half of next year.”
The pause will be in place until four conditions are met: credentialling of surgeons to carry out mesh insertion and removal; a registry of all mesh patients; multi-disciplinary meetings to review patients; and a new informed consent process.
The informed consent work had been completed, but all of the other conditions were still being worked on.
The registry, which will collect data on all public and private patients who get mesh operations, was taking the most time to complete, Bourne said.
The ministry did not provide a figure for how many doctors had been approved through the credentialling process, but Bourne said he was hopeful there would be enough surgeons to provide the full range of procedures for women across the country by the end of the year.
The ministry had also introduced an “exceptions” system for cases in which surgeons believed mesh was the only option for a patient.
Ministry of Health chief medical officer Dr Joe Bourne. Photo / Andrew Warner
Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) vice-president Dr Susan Fleming said it was not surprising that it was taking longer than first indicated to resume mesh operations. It was a tricky field and the ministry needed to be sure the needs of all parties, including patients, were met before proceeding, she said.
Fleming said the pause had some knock-on effects, including longer waits for women seeking treatment for stress urinary incontinence and prolapse.
She said surgeons had also reported concerns about not doing enough operations to maintain their surgical skills.
“The obstetrics side of our work is very hungry at the moment. That already puts pressure on access to surgical time and the proportion of time that clinicians have to devote to gynaecological care,” Fleming said.
“If you layer on that restricted access to surgery and certain procedures not coming through the clinics, then you start to have a worry about whether surgeons will maintain those surgical skills.”
The pause followed a petition to Parliament led by patient advocates Sally Walker and Charlotte Korte, who had been injured by botched operations.
Walker said she supported the decision to keep the mesh pause in place.
“I’d like it to be in place a lot longer because I don’t think it should be a tick-box exercise. There is a long way to go and that high standard hasn’t been met.”
Walker said she wanted the names of surgeons who had been credentialled to be published so patients could make informed decisions when they were seeking treatment.
In some cases, surgeons were asking patients to sign forms for mesh operations when the suspension was lifted, she said.
“I believe that is wrong, because unless these patients know these surgeons have been credentialled, they are once again going into the lion’s den.”
She said there had never been an acknowledgement or apology from the sector about the harm that had been done to patients.
“I am still in pain,” said Walker, whose complications stemmed from an operation in 2009. “The mesh is coming away again. I am reminded every day of that harm that was done to me by looking at my stomach bag.”
Isaac Davison is an Auckland-based reporter who covers health issues. He joined the Herald in 2008 and has previously covered the environment, politics and social issues.
