UK decision to pause mid urethral sling surgeries causes doctor despair.
Time to talk commonsense on incontinence treatments.
Q&A with Dr Jenny King, Chair, UGSA
- Can you briefly tell us your reaction to the suspension of mesh implants in the UK?
- The sudden suspension of mesh implants for prolapse and incontinence in the UK is really concerning. This goes against all of our experience, all of our research, all of our data, and it also disregards those women who after consideration have really thought that they’d like to have a mid-urethral sling for their incontinence.
- Why are you concerned about the implications for Australia (and Australian women)?
- In the UK, they’ve had a working party last year that produced a really substantial report. It had every medical regulatory body. It had every surgeon’s organization, their Clinical Excellence Commission involved. So what we now see is a parliamentary committee which is not medically trained and which isn’t using any of the medical evidence to overturn what these really knowledgeable people have suggested.
- In essence, what’s your organisation’s position on the use of mesh slings for urinary incontinence?
- In Australia, as in the UK, our experience over the last few years with women and adverse outcomes with mesh, has led us to have really good, safe and sensible restrictions and guidelines for the use of mesh. Now, if that can be disregarded in the UK, it can be disregarded in Australia.
UGSA feels really strongly that the mesh sling for incontinence are really the most researched continence procedure in medically history. We have 20 years of data. We have follow-up on millions of women world-wide. And truly if you find that conservative management hasn’t helped your incontinence, a mid-urethral sling is a really good option.
- What would you say to people who might be concerned following reports of complications associated with these mesh implants?
- We quite understand how anxious women will be after a lot of the excess publicity. I do think, however, we understand much more about the use of mesh slings, women who may be more suitable or less suitable, and how to deal with those complications. Remember too, over 95% of women who’ve had a sling, have had a really good outcome.
I am concerned that women in rural and regional areas don’t have access to quite the same facilities as women on the cities, and certainly they may not have the specialists physiotherapy, or the specialist surgeons. This is something we really have to work on, and I think realistically for a lot of women in more rural areas, they may need to travel to get the treatment they need.