On this page
- Announcement
- Update on the use of surgical mesh for Stress Urinary Incontinence - 23 August, 2023
- About our service
- New Zealand Female Pelvic Mesh Service Leads
- How to access the service
- Who can get support
- What to expect from this service
- Location and travel information
- Our surgeons
- Pelvic mesh and complications from surgery
- Resources
- Frequently Asked Questions
- Have more questions?
Announcement
Congratulations to the NZFPMS Consumer Advisor Sally Walker on her recent award as Kiwibank New Zealand Local Hero of the Year 2024 and for her appointment as Member of the New Zealand Order of Merit for services to health advocacy.
Update on the use of surgical mesh for Stress Urinary Incontinence - 23 August, 2023
There is now a time-limited pause on the use of surgical mesh for stress urinary incontinence (SUI). The pause is expected to be in place for a number of months.
The reason for the pause is to enable health providers to take steps to minimise harm linked to the procedure, which will result in better outcomes for patients who have mesh inserted as part of their incontinence treatment. Please note: this is the only surgical mesh procedure that has been paused.
Patients who are directly affected by this decision, including those currently waiting for a stress urinary incontinence procedure which may include mesh insertion, have been, or will shortly be contacted by their local Health NZ District Hospital to discuss their ongoing management plan. Those receiving treatment in a private facility can expect to be contacted by their clinician. Each plan is likely to be different depending on individual circumstances but could range from additional non-surgical management (e.g., pelvic floor physiotherapy), to a different surgical procedure or to wait until the pause is lifted.
People needing to know more can find information on the Manatū Hauora website, or talk to their GP or specialist.
For all other information regarding the New Zealand Female Pelvic Mesh Service please continue below.
About our service
A new national service has been established to support and care for women who have suffered injury from having pelvic surgical mesh put into their bodies during surgery.
For the purposes of this service the word female refers to individuals born with female pelvic organs (vagina, uterus and ovaries). It does not make any judgement about whether individuals identify as male, female or non-binary.
Where the word consumer or women/woman is used in these pages we are referring to individuals who are female, as described above.
We care about women's health
Health NZ acknowledges the extreme pain and distress caused to women who have experienced complications as a result of pelvic mesh surgery. The New Zealand Female Pelvic Mesh Service is a holistic and wraparound service that has been established to support and care for women who have suffered injury from having pelvic surgical mesh put into their bodies during surgery.
It has been designed in partnership with mesh-injured consumers, Māori and Pacific health representatives and medical professionals, and in collaboration with ACC. Specialist surgeons, specialist nurses, physiotherapists and pain specialists were also involved.
A women’s choice is at the centre of this service. Your journey with us starts with understanding your experiences, needs and goals. The Navigators and Nurse Specialists will support you every step of the way.
Treatment and care options will be discussed with you. The service will work with you to develop your individual treatment and care plan, and treatment will only be provided if you agree.
Care and support options include:
- continence care
- pain management
- physiotherapy
- psychologists
- surgery
- cultural and language support
- spiritual support.
If you need to contact us you can use this email address. Please note that due to clinical commitments that the team aim to respond within 2-working days. nzfpms@tewhatuora.govt.nz
Updates on waiting times
We understand that waiting for an appointment can be concerning.
We are happy to advise that the measures taken to shorten the previously extended wait times for initial contact with our health team have been successful. Our current wait times are now comparable to other Health New Zealand services.
Referrals to our Service are carefully reviewed and prioritised. You will receive a letter with details on when you can expect to be contacted by a member of our health team. Please note that waiting times may vary depending on the urgency of your condition and staff availability. The longest you can expect to wait is 4-months.
If you are worried that you have been forgotten, or that you haven’t heard from someone in the team for a while and want to connect with us, you can contact the team on nzfpms@tewhatuora.govt.nz, call the number on your referral acceptance letter or ask your GP practice to call the team for a clinical update.
Thank you, we do appreciate your patience.
Where we are
The Service will be based in two locations - Ōtautahi (Christchurch) and Tāmaki Makaurau (Auckland). Not all appointments or assessments will need to be held in these physical locations. Phone or video consults will be available as appropriate. If you are required to attend an appointment or assessment in person, travel and accommodation expenses may be covered for yourself and a support person.
The Health Navigator will help connect you with the National Travel Scheme to assess your eligibility, or if you may be eligible for travel assistance as part of having an ACC claim accepted.
The service reflects recommendations from the 2019 restorative justice project on surgical mesh: Hearing and Responding to the Stories of Survivors of Surgical Mesh.
New Zealand Female Pelvic Mesh Service Leads
National Co-Lead appointments for New Zealand Female Pelvic Mesh Service
We are delighted to welcome Eva Fong - Health NZ Waitematā and Giovanni Loso - Health NZ Waitaha | Canterbury to the roles of National Co-Leads of the New Zealand Female Pelvic Mesh Service.
Eva and Giovanni bring with them a wealth of expertise in the specialist area of urology. Both are highly skilled and have extensive specialist expertise gained both internationally and in New Zealand. You can find their bios below.
These appointments mark a further step towards developing and delivering a national specialist service for women experiencing complications from pelvic surgery as well as creating national clinical leadership across key services.
The Female Pelvic Mesh Service was developed to support and care for women who suffered injury from pelvic surgical mesh. The service offers holistic and wraparound service to women and their whānau.
The service was co-designed in a partnership with mesh-injured consumers, Māori, Pacific and Asian health equity representatives, health professionals and business partners and in collaboration with ACC.
Both Health NZ and Te Aka Whai Ora have been involved in the appointment process which underpins partnership as a foundational principle of the networks.
We congratulate Eva and Giovanni - they each offer a wealth of inter-professional clinical expertise and experience. Both also bring diversity of thought for women, whānau and communities impacted by complications associated with surgical mesh.
As we continue to build on the Female Pelvic Mesh Service, our goal is to ensure inclusive and diverse leadership to support the delivery of equitable access to high quality health services across primary, community and secondary care.
Richard Sullivan
Interim Chief Clinical Officer
Hospital & Specialist Services
Dr Eva Fong
Dr Eva Fong
Eva is a New Zealand-trained Auckland urologist specialising in pelvic floor disorders and complications.
She was born and raised in Wellington, attended the University of Auckland School of Medicine and completed the Royal Australian College of Surgeons Advanced training in urology.
Eva then undertook a two-year American Board of Obstetrics and Gynecology /American Board of Urology accredited fellowship in Female Pelvic Medicine and Reconstructive Surgery. Eva has been a member of the Urology team at Te Whatu Ora Waitemata since 2011.
Her work has included being a member of Manatū Hauora Surgical mesh roundtable. She is also a member of the International Continence Society mesh complications committee with forthcoming publications as lead author of "Diagnosis and treatment of vaginally inserted pelvic organ prolapse mesh complications" and Surgical Training and Research in Mesh Complications.
Eva has been involved in several aspects of mesh complications work and particularly values the lessons she has learnt from consumer co-design work and from participating in the Restorative Justice process.
One of Eva's many strengths is her unwavering dedication and commitment to the wellbeing of her patients.
Eva's expertise in her Urology Specialist field is highly valued and recognised by her colleagues and peers here in New Zealand and overseas.
In her spare time Eva and her husband are kept busy with their three children and their numerous activities.
Mr Giovanni Losco
Mr Giovanni Losco
Originally from Christchurch, Giovanni completed subspecialty training in urology in the United Kingdom.
He completed fellowship training in paediatric urology at Birmingham Children’s Hospital and gained extensive experience in reconstructive urology, female urology, pelvic organ prolapse, urethroplasty and urological care of spinal injuries while working at the London Spinal Cord Injury Centre, Royal National Orthopaedic Hospital and the Institute of Urology, University College Hospital, London. Prior to that, he worked at Concord Repatriation General Hospital in Sydney where he focussed on bladder dysfunction with a particular interest in male and female incontinence.
Before leaving New Zealand, Giovanni undertook his Fellowship of the Royal Australasian College of Surgeons training in Christchurch, Wellington and Palmerston North, after graduating from the University of Otago
Alongside maintaining an interest in general urology in both adults and children, Giovanni holds a number of leadership positions: Clinical Director of Urology, Te Whatu Ora Waitaha Canterbury; Chair, NZ Urology Clinical Directors’ Group; Director, Urology Associates; Trustee, Canterbury Urology Research Trust; Clinical Senior Lecturer, University of Otago, Christchurch; Examiner in Urology, Royal Australasian College of Surgeons; Prevocational Educational Supervisor, Medical Council of New Zealand; Clinical Lead for Urology at Te Whatu Ora South Canterbury and Urology
Associates Whakatipu; Consultant Urologist, Burwood Spinal Unit; and sits (or has sat) on a number of ACC and Manatū Hauora committees concerning reducing harm from surgical mesh.
Giovanni enjoys living in his hometown of Christchurch with his wife Emma and their three girls.
How to access the service
Please note that we are unable to accept referrals sent to this email and will return them. Referrals can be sent through your normal electronic e-referrals pathway. If you do not have a referral tool, please contact ERMS, BPAC or HealthLink to set up free access.
If you are experiencing symptoms you think may be related to pelvic mesh, please talk to your GP or specialist about being referred to the New Zealand Female Pelvic Mesh Service.
If you are a GP or specialist and need to contact us, please use this email address nzfpms@tewhatuora.govt.nz
See your local HealthPathways for further information about the service and how to send an electronic referral.
How it works
If your referral is accepted you will be contacted by a member of the team, this may be to set up appointments to meet the Navigator, Nurse Specialist or doctor, or it may be to ask some questions that help the team plan any investigations that may be needed.
Patients will be offered the opportunity to share their journey and experiences since surgical mesh was implanted. Capturing your journey helps the team understand your needs and experiences, and guide them on potential ways to help you, and what matters to you.
Our multidisciplinary team will work through treatment options that may suit your situation and work on a treatment, care and support plan, to discuss with you. You will be invited to an appointment where treatment and care options will be discussed with you. Surgery, to remove the mesh and/or repair damaged tissue, may be discussed with you as part of your treatment plan, however, for some people surgery may not be the best option. The service will work with you to develop your individual treatment and care plan, and treatment will only be provided if you agree.
You will continue to be looked after by the New Zealand Female Pelvic Mesh Service until you and the clinical team agree that the treatment goals you and the surgeon agreed for you have been met.
If it is determined that you have an injury caused by pelvic mesh, the team will work with you to submit a claim to the Accident Compensation Corporation (ACC).
Who can get support
Consumers who have had any of the following pelvic mesh procedures and are eligible for New Zealand health care or ACC can be referred to the New Zealand Female Pelvic Mesh Service:
- All pelvic mesh inserted for pelvic organ prolapse (POP)
- All pelvic mesh inserted for stress urinary incontinence (SUI)
- Pelvic mesh inserted for rectal prolapse (rectopexy) if another type of pelvic mesh for either POP or SUI was also inserted. If only rectopexy mesh was inserted you will be referred to a colorectal specialist instead.
Mesh used for hernia repair in the pelvic region is not currently included in this service.
Note: You can access the New Zealand Female Pelvic Mesh Service if you are eligible for publicly funded health and disability services in New Zealand or if your GP or specialist believe your mesh complications may be covered by ACC as Treatment Injury ACC.
For more information see pelvic mesh injury on the ACC website.
Rectopexy mesh treatment injuries are assessed and managed within general claim management at ACC. Treatment injury claims are assessed on a case-by-case basis regarding the client’s needs.
If you have Rectopexy mesh only and believe you might be experiencing symptoms that are related to a complication, you may find more information about ACC support and the client journey here:
- Help for pelvic mesh injuries: Pelvic mesh injury (acc.co.nz)
- Surgical mesh report: ACC taking action to improve client experience and health outcomes
- Treatment Injury Guide: 855206-ACC7972-TI-claim-guide-Mar2019-Pr08.indd
What to expect from this service
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After your referral is accepted you will be contacted by a member of the team, this may be to set up appointments to meet the Navigator, Nurse Specialist or doctor, or it may be to ask some questions that help the team plan any investigations that might be needed.
We understand that it can be frustrating and traumatic to constantly be asked to repeat your journey with every new health person. To reduce the potential of this happening, we offer all patients the opportunity to capture their journey and experiences. Sharing your experiences like this is optional, choosing not to share it in this way will not impact your care. If you decide to proceed a Health Navigator will contact you to explain the process, give you options on how to do it and what happens when they document it for the health team, they will explain how it happens.Once it is written up you will be asked to read it and make any corrections or additions and it will be entered into your medical records so people involved in your treatment will be familiar with it and you won’t have to keep retelling it. -
The Health Navigators role is to support you every step of the way as you journey through this service. Our navigators are based in both centres, and work with women from all over the country.
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The GP or specialist who has referred you, will have sent through any relevant medical records with your referral. It may be determined that some additional investigations are needed to be able to help prioritise the care that you need. If this is the case, these will be discussed with you and booked as appropriate. Some people may be eligible for National Travel Assistance or for assistance as part of having an ACC claim accepted to travel for these investigations. A member of the team will talk to you about this.
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You are encouraged to have a support person with you for all appointments, including phone and video appointments. If you can’t bring someone with you, the Health Navigator can support you if you wish.
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Ensuring you have access to cultural, spiritual or language support throughout your journey with the Service is important. If at any time you would like us to arrange a person to support you with this, please ask the Health Navigator.
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It is important that we gather the right information to help understand your situation. Once we have that, the multidisciplinary team, which may include a combination of credentialled surgeons, specialist nurses, pain specialists, physiotherapists, social workers, psychology services and occupational therapists, will get together to discuss your case. They will work through treatment options that may suit your situation and work on a treatment, care and support plan, to discuss with you. You will be invited to an appointment where treatment and care options will be discussed with you. Surgery, to remove the mesh and/or repair damaged tissue, may be discussed with you as part of your treatment plan, however, for some people surgery may not be the best option. The service will work with you to develop your individual treatment and care plan, and treatment will only be provided if you agree.
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The service ensures best care through regular Multidisciplinary Team Meetings (MDM), where your medical history is reviewed, and treatment options are discussed and agreed by a team of doctors, nurses, and allied health professionals skilled at managing complications from surgical mesh. The team discusses and proposes an individual treatment plan based on established medical guidelines and current evidence that has been thoroughly researched and published, where there is an absence of research best practice guidelines are applied. Best practice guidelines are established and widely accepted methods or protocols to achieve safe optimal outcomes, they are based on extensive experience, expert consensus, and evidence from various sources. This approach ensures all treatment options are considered and tailored to your goals. All participants adhere to confidentiality agreements, and the process complies with the Health Information Privacy Code and the Privacy Act 2020.
The Patient Information Guide to MDM has been developed with mesh injured consumers, to help you understand this important step in your health journey.
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You will continue to be looked after by the New Zealand Female Pelvic Mesh Service until you and the clinical team agree that the treatment goals you and the surgeon agreed for you have been met.
Location and travel information
If you have complications related to pelvic surgical mesh, you can access this new service from anywhere in Aotearoa New Zealand.
The New Zealand Female Pelvic Mesh Service will be based in two locations:
- Ōtautahi Christchurch
- Tāmaki Makaurau Auckland
Treatment may also be provided at other locations where team members are based.
Not all appointments or assessments will need to be held in these physical locations. Phone or video consults will be available as appropriate. If you are required to attend an appointment or assessment in person, travel and accommodation expenses may be covered for yourself and a support person.
Our surgeons
The surgeons in our team have been credentialled for mesh complication work at Tier 3 of the Ministry of Health National Credentialling Framework – Pelvic floor reconstructive, urogynaecological and mesh revision and removal procedures.
Tier 1 Credentialled Surgeon Procedure list
Tier 1 Credentialled Surgeon Procedure list
|
Eva Fong |
Giovanni Losco |
Hazel Ecclestone |
Sum Sum Lo |
---|---|---|---|---|
High uterosacral ligament suspension (transvaginal or laparoscopic) |
Yes |
Yes |
No |
Yes |
Non-mesh apical suspension (without permanent sutures) |
Yes |
Yes |
No |
Yes |
Sacrospinous fixation/hysteropexy (without permanent sutures) |
Yes |
Yes |
No |
Yes |
Acute Non-Mesh Revision |
||||
Repair of wound dehiscence along suture line |
Yes |
Yes |
Yes |
Yes |
Treatment of haematoma and infection |
Yes |
Yes |
Yes |
Yes |
Tier 2 Credentialled Surgeon Procedure list
Tier 2 Credentialled Surgeon Procedure list
|
Eva Fong |
Giovanni Losco |
Hazel Ecclestone |
Sum Sum Lo |
---|---|---|---|---|
Retropubic MUS insertion |
Yes |
Yes |
No |
Yes |
Sacrocolpopexy |
Yes |
Yes |
No |
Yes |
Sacrohysteropexy |
Yes |
Yes |
No |
Yes |
Sacrospinous hysteropexy (with permanent sutures) |
Yes |
No |
No |
Yes |
Autologous sling |
Yes |
Yes |
Yes |
Yes |
Burch colposuspension |
Yes |
No |
Yes |
No |
Urethral bulking agents |
Yes |
Yes |
Yes |
Yes |
Acute loosening for voiding dysfunction |
Yes |
Yes |
Yes |
Yes |
Acute division for voiding dysfunction |
Yes |
Yes |
Yes |
Yes |
Vaginal division of MUS for obstruction |
Yes |
Yes |
Yes |
Yes |
Trimming (excision) of ˂1cm exposed vaginal mesh |
Yes |
Yes |
Yes |
Yes |
Tier 3 Credentialled Surgeon Procedure list
Tier 3 Credentialled Surgeon Procedure list
|
Eva Fong |
Giovanni Losco |
Hazel Ecclestone |
Sum Sum Lo |
---|---|---|---|---|
Retropubic Mid-Urethral Sling |
Yes |
Yes |
Yes |
Yes |
Transobturator Mid-Urethral Sling |
Yes |
No |
No |
Yes |
Anterior/Posterior Vaginal Prolapse Mesh, body & arms |
Yes |
No |
No |
Yes |
Orphan Arms |
Yes |
No |
No |
Yes |
Sacrocolpopxy vaginal attachment mesh |
Yes |
No |
No |
No |
Reconstruction following |
Yes |
No |
Yes |
Yes |
Autologous Sling revision & removal |
Yes |
Yes |
Yes |
Yes |
* Note: gynaecologists, urogynaecologists and urologists are not expected to be credentialled for removal of mesh from the bowel. This work is within the colorectal domain of practice. (Reference: The National Credentialling Framework, 2022).
When you are referred to the service you can be confident that you will be seen by a surgeon who is credentialled for a procedure that is particular to your mesh complication needs.
The credentialling process for all tiers of work is ongoing. The National Credentialling Committee will advise Health New Zealand of additional practitioners who achieve full credentialled status in the coming months.
For more information see the National Credentialling Framework: Pelvic floor reconstructive, urogynaecological and mesh revision and removal procedures on the Ministry of Health website.
Pelvic mesh and complications from surgery
Surgical mesh is a medical device used to repair and provide support to parts of your body that have become weakened. Pelvic mesh is a type of surgical mesh. It is a synthetic implant that is made from a non-absorbable polypropylene (plastic) material. It is known by multiple names including tape, sling, TVT, patch, ribbon, graft or hammock. A mesh implant is used to support and hold your urethra, similar to the function of ligaments that are weakened in the case of incontinence. It will stay in your body permanently as it is non-absorbable.
Transvaginal mesh was previously used to repair pelvic organ prolapse (POP) prior to 2017, however regulatory action in 2017 banned its use in New Zealand. Abdominal surgical mesh is currently used in New Zealand to treat pelvic organ prolapse and rectal prolapse.
Some people have pelvic mesh implants with no complications and good outcomes. However, this is not true for everyone. Some people suffer complications leading to injuries which can be anywhere from minor to serious and life-changing. An added complication is that harm from pelvic mesh can cause symptoms immediately following surgery, or it can be years down the track before any symptoms start. Some of the possible pelvic mesh-related complications include:
- Erosion is where mesh pushes against and into the surrounding tissue, nerves and organs. Erosion can occur years after surgery with the most common being erosion into the vagina.
- Extrusion is where mesh pushes through or perforates surrounding tissue, nerves and organs including the bladder, urethra or bowel.
- Infection of damaged tissues, with recurrent urinary tract (bladder) infections being the most common.
- Inflammation caused because the mesh is a foreign body that activates an immune response.
All of these complications can result in acute and/or chronic pain as well as other symptoms.
Restorative Justice process
In 2019, Manatū Hauora - Ministry of Health led a process to hear directly from New Zealand people affected by implanted surgical mesh. This programme focused on anyone who had been impacted by injury and harm from the insertion of surgical mesh in Aotearoa.
The restorative justice project heard numerous stories from women with complications.
These were independently analysed by a team from the Diana Unwin Chair in Restorative Justice, Victoria University of Wellington, and resulted in the report Hearing and Responding to the Stories of Survivors of Surgical Mesh.
This report describes significant harm with extensive impact on quality of life for the women and whānau affected.
New specialist service among the action points
The report highlighted 19 recommendations and action points. The establishment of a specialist service to assess and deliver treatment options for consumers suffering from post-mesh implantation complications was Action number 8.
The New Zealand Female Pelvic Mesh Service is for those women and their whānau living with complications.
Manatū Hauora - Ministry of Health contracted the then Northern and Southern region District Health Boards to scope and co-design, with consumers harmed by surgical mesh, options for the delivery of these services. The services needed to be nationally consistent, consumer-centred, high quality and accessible to everyone, with barriers to treatment removed.
A credentialling framework has also been created for surgeons who offer treatment for consumers experiencing complications associated with implanted mesh.
A global issue
A similar process to remediate people suffering from pelvic mesh complications has been undertaken in Australia and the UK.
Surgical mesh is a worldwide issue and has caused avoidable harm to hundreds of thousands, and possibility millions of people. Opinions in the medical industry are contentious and divided and use of mesh continues today around the world.
You are not alone
Many women have struggled with complications from the use of surgical mesh in operations.
They have shared their often painful stories in the ‘Hearing and Responding to the Stories of Survivors of Surgical Mesh’ report, part of the Restorative Justice Project to address the sometimes poor outcomes to their surgery.
Those stories and their voices have created a powerful chorus for change. Te Whatu Ora and others have listened and worked with them to create an action plan to make those changes happen.
Resources
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Download: Infographic of how the service works - PDF, 286 KB
An easy-to-follow process to help you navigate this new service -
Download: Patient guide to the multidisciplinary team meeting - PDF, 161 KB
A guide to the multidisciplinary team process -
Download: Flyer for GPs - PDF, 507 KB
Information about Pelvic Mesh Service for GPs
Frequently Asked Questions
If I have an injury from pelvic mesh what support is available to me?
If I have an injury from pelvic mesh what support is available to me?
The New Zealand Female Pelvic Mesh Service has been set up for women experiencing complications from certain operations involving the use of surgical mesh.
A referral is required from a GP or specialist. If your referral is accepted, a member of the NZFPMS team will be touch to offer support for your ongoing journey.
If an injury caused by pelvic mesh is suspected, a claim will be lodged to the Accident Compensation Corporation (ACC).
ACC will investigate the claim and collect information provided by the New Zealand Female Pelvic Mesh Service to help inform its cover decision.
If cover is approved, you will be appointed a recovery team member who will help coordinate your entitlements on a case-by-case basis. This can include costs associated with:
- Diagnostics, investigations and assessments
- Treatments (both surgical and non-surgical)
- Weekly compensation
- Transport and accommodation
- Home and community support
- Equipment and consumables
- Rongōa services
Where is the New Zealand Female Pelvic Mesh Service located?
Where is the New Zealand Female Pelvic Mesh Service located?
The service will be based in two locations - one in Ōtautahi Christchurch and the other in Tāmaki Makaurau Auckland. Not all appointments or assessments will need to be held in these physical locations. Phone or video consults will be available as appropriate for people who live outside of these areas.
lf you are required to attend an appointment or assessment in person, travel and accommodation expenses may be covered for yourself and a support person. Your Health Navigator will be able to help with that process.
What is pelvic mesh and what are the different names used for it?
What is pelvic mesh and what are the different names used for it?
Surgical mesh is a medical device used to repair and provide support to parts of your body that have become weakened. Pelvic mesh is a type of surgical mesh. It is a synthetic implant that is made from a non-absorbable polypropylene (plastic) material. lt is known by multiple names, including tape, sling' TVT, patch, ribbon, graft or hammock. A mesh implant is a permanent support used to support your urethra and hold your weakened organs in place.
These devices are designed to be a permanent implant. The most common procedure involving mesh is known as a mid-urethral sling (MUS) procedure, used to treat stress urinary incontinence. Pelvic mesh is also used to treat pelvic organ prolapse. lt is used to treat rectal and bowel prolapse in a procedure called a rectopexy.
What types of pelvic mesh complications does the New Zealand Female Pelvic Mesh Service see?
What types of pelvic mesh complications does the New Zealand Female Pelvic Mesh Service see?
- All types of pelvic mesh inserted for pelvic organ prolapse (POP)
- All types of pelvic mesh inserted for stress urinary incontinence (SUI)
- Patients with pelvic mesh inserted for POP or SUI, and who also have mesh inserted for rectal prolapse (rectopexy)
- Non-mesh slings for SUI will also be included if complications have occurred.
The Service is currently not taking referrals for consumers who have had a single procedure for rectal prolapse (rectopexy).
If you have had a rectopexy and mesh was inserted, and you are experiencing problems you will need to see your family doctor and discuss this, you may be referred to the colorectal services.
Should I be concerned if I have pelvic mesh?
Should I be concerned if I have pelvic mesh?
Some women have pelvic mesh implants with no complications and good outcomes. However, this is not true for all women. Some women suffer complications leading to injuries which can be anywhere from minor to serious, severe and life-changing.
An added complication is that harm from pelvic mesh can cause symptoms immediately following surgery, or it can be years down the track before any symptoms start. This is because pelvic mesh hardens over time and as it hardens it can begin to push into and damage surrounding tissues, organs and nerves. It can also move inside your body or become infected or inflamed.
lf you have had pelvic mesh implanted and begin experiencing symptoms, talk to your doctor or specialist.
What are some of the possible pelvic mesh-related complications?
What are some of the possible pelvic mesh-related complications?
- Erosion is where mesh pushes against and into the surrounding tissue, nerves and organs. Erosion can occur years after surgery with the most common being erosion into the vagina.
- Extrusion is where mesh pushes through or perforates surrounding tissue, nerves and organs, including the bladder, urethra or bowel.
- lnfection of damaged tissues, with recurrent urinary tract or bladder infections the most common complication.
- lnflammation can result because the mesh is a foreign body that activates an immune response.
All of these complications can result in acute or chronic pain, as well as other symptoms.
What symptoms might I notice if I have a pelvic mesh complication?
What symptoms might I notice if I have a pelvic mesh complication?
Symptoms that may be associated with pelvic mesh implant complications include:
- Pain or spasms at the site of the mesh implant, including vaginal, groin, pelvic area, lower abdominal, lower back, buttock, and referred pain down one or both legs.
- Urinary tract (bladder) infections.
- Vaginal discharge.
- Difficulty urinating.
- Excessive vaginal or urinary bleeding (note that this can be normal)
- Pain during sexual intercourse an or painful sex experienced by the partner when they feel the mesh during sexual intercourse.
- Abscess or swelling at the mesh insertion or exit sites.
- lncreased anxiety.
What should I do if think pelvic mesh is affecting my health?
What should I do if think pelvic mesh is affecting my health?
The first step is to talk to your GP or specialist about your symptoms and let them know that you have a pelvic mesh implant. If appropriate they will refer you to the New Zealand Female Pelvic Mesh Service. ln some cases it may be appropriate for them to begin managing your symptoms such as pain or anxiety while waiting for your referral to be accepted.
Once your referral is received it will be assessed. The more information your doctor can provide to support your referral the better. This may mean asking for surgical notes if your operation was not recent. It may also involve your doctor asking some questions which may be personal and uncomfortable for you. These questions are important to help identify if your symptoms are from surgical mesh.
What is the New Zealand Female Pelvic Mesh Service?
What is the New Zealand Female Pelvic Mesh Service?
The New Zealand Female Pelvic Mesh Service is a new national service that has been established to support and care for women who may be experiencing complications from having pelvic surgical mesh put into their bodies.
The service consists of a team of health providers from many different specialties such as credentialled surgeons, nurses, physiotherapists, pain physicians, occupational therapists, social workers, and pyschologists. They are committed to caring for women respectfully, transparently, and in a supportive environment. This is called a multi-disciplinary approach, with the consumer (you), as a partner in your healthcare team.
My referral to the Pelvic Mesh Service has been declined, now what?
My referral to the Pelvic Mesh Service has been declined, now what?
Your options will depend on the reason your referral was declined.
Sometimes, after the pelvic mesh service staff have gathered all of the required information, it is found that mesh was not inserted or it is not the reason for your symptoms. If they determine that mesh has not been inserted they will let your family doctor know and if appropriate make recommendations to support you further.
Some referrals received by the pelvic mesh service may be for women who have had mesh inserted, but not in the pelvis, for example mesh used to repair a hernia. If this is the case, you should see your GP or Specialist regarding management of this, which may include referral to a surgeon.