Articles - United Kingdom

Dated: 22nd April 2011

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United Kingdom

22nd April 2012
A standardized description of graft-containing meshes and recommended steps before the introduction of medica devices for prolapse surgery. Consensus of the 2nd IUGA Grafts Roundtable: Optimizing Safety and Appropriateness of Graft Use in Transvaginal Pelvic Reconstructive Surgery.‏
Please read the full PDF on the link below:
Consensus of the 2nd IUGA Grafts Roundtable.pdf >>>
Comment: What the heck is going to happen for all those people injured over the past decade? we won't be hidden and brushed under the carpet.

22nd April 2012
SURGICAL MASTERCLASS IN UROGYNAECOLOGY - MEETING AT RCOG‏
To view full details please click on the PDF link below:
SurgicalMasterClassinUrogynaecology.pdf >>>
Comment: There are lots of sessions about putting mesh in but none about how to take it out or deal with the complications.
There is also very little about patient consent, offering conservative non-surgical management or not doing operations of dubious value.
Many of these new operations are either totally unnecessary or are of such limited benefit that extreme caution should be observed. Unfortunately many gynaecologists are effectively trying to ' sell ' these procedures to their patients.

New Patient Advice
www.tvt-messed-up-mesh.org.uk/new-patient-advice.html >>>>

News from the MHRA
www.tvt-messed-up-mesh.org.uk/news-from-the-mhra.html >>>>

The British Journal of Radiology, 77 (2004), 261–265 E 2004 The British Institute of Radiology DOI: 10.1259/bjr/63333975
Pictorial review Prosthetic mesh used for inguinal and ventral hernia repair: normal appearance and complications in ultrasound and CT
How the Radiologist's can read an Ulrasound and CT Scan to pick up any abnormalities arising from the TVT Sling and Mesh radiologtic-appearance-of-mesh-on-ultrasound-CT-scan.pdf

EUROPEAN UROLOGY 5 6 ( 2 0 0 9 ) 3 7 1 - 3 7 7
Correction of Erosion after Suburethral Sling Insertion for Stress Incontinence: Results and Related Sexual Function. Click to read >>>>

Thousands of people face painful and expensive surgery to remove failing medical devices such as metal hip replacements and cardiovascular implants, according to investigations by the BMJ and Channel 4 Dispatches.

From our Medical Expert Advisor: The problems with vaginal meshes is just as serious as the hip and cardiac devices but it has not received the same publicity. The MHRA has been severely criticised for doing very little and the commercial activities of the companies involved have been a disgrace.
www.tvt-messed-up-mesh.org.uk/british-medical-journal.html >>>>

This article dated for the year 2006 is in the public domain there has been 10 deaths After this year date it is unknown to the public how many more have died. Please read this PDF from the BMJ page 16 BMJ (British Medical Journal) - harms-with-medical-devices-2007

The above is what we have found from doing our own research. What is the true number of people suffering and deaths. Is this hidden?

The MHRA, NICE and the NHS owe us a full investigation on this growing health problem around the UK and Worldwide.

To get this eroding mesh stuff out of our bodies involves multiple surgeries and causing genital mutilation. PLEASE HELP US!

9 June 2010 - Time is a great factor, the truth will be revealed, we will wait, watch and see things unfold before our very eyes....
Health Secretary Andrew Lansley mentions Hospitals to face financial penalties for readmissions By Michelle Roberts Health reporter, BBC News

PLEASE READ THIS IMPORTANT ARTICLE from the British Medical Journal (BMJ)
Title: Take note those advocating the use of mesh in hernia repairs
Richard G Fiddian-Green, FRCS, FACS.
Five years ago I wrote, in addressing the use of mesh in herna repairs, "Inserting an open mesh in a patient is akin to inserting a limpet mine. It may never be hit by a ship but if it is it could sink it. The risk is of infection developing in the mash latter years during the course of another illness, such as an AP resection which requires the formation of an adjacent colostomy or admission to an ICU for organ dysfunction. In the latter instance the mesh could become an occult nidus of

More... Five years ago I wrote, in addressing the use of mesh in herna repairs, "Inserting an open mesh in a patient is akin to inserting a limpet mine. It may never be hit by a ship but if it is it could sink it. The risk is of infection developing in the mash latter years during the course of another illness, such as an AP resection which requires the formation of an adjacent colostomy or admission to an ICU for organ dysfunction. In the latter instance the mesh could become an occult nidus of infection that kills the patient" (1).

In examing the risks of herniorrhaphy further I also wrote, "One of the risks in doing a herniorrhaphy is causing infertility by obstructing the vas deferens. The incidence of obstruction, which may be reversible, is reported to be as high as 26.7% in subfertile patients with a history of childhood herniorrhaphy. Furthermore "immunoglobulin (Ig)G and IgA class antisperm antibodies, which contribute to infertility, have been found to be positive in 55% and 18% of those patients with a vasal obstruction caused by inguinal herniorrhaphy and in 60% and 20% of vasectomized patients respectively; whereas these antibodies were positive in 13% and 0% of those patients with an epididymal obstruction of unknown etiology and in 8% and 3% of those patients with congenital bilateral absence of the vas deferens"....In looking at the problem from a different perspective "10 infertile men found to have sperm-agglutinating antibodies in serum and a history of inguinal herniorrhaphy the site of the previous operation was explored. Five of the men had an occlusion of the vas deferens and in three others spermatoceles were noted in the epididymis. The occlusion of the vas deferens was in the area of the previous herniorrhaphy". If obstruction of the hard-walled vas can occur so commonly what of arterial and especially venous obstruction? Is it not likely to be far more common even if not manifest as a varicocele?"(2).

Hernia repairs are bread-and-butter for those in private practice and are a significant cost and major headache for managers in the NHS and VA hospitals in the US because of the difficulty in getting consultants to clear their waiting lists. Its a contraversial subject. Some, such as Professor Meakins, are very conservative advocating that surgery be restricted to those that become symptomatic.

Four years ago, the Department of Health asked Professor Meakins, then Nuffield Professor of Surgery at Oxford, to write a list of criteria for hernia surgery. "He concluded that repair should be offered only when the hernia is painful and growing; where the patient has a history of complications; where the patient's job is dependent on the repair, or if the patient demands it" (3). He admits to having had hernias himself for decades and having had nothing done about them.

Professor Hobsley, another advocate of a more conservative approach, tried to obtain a factual basis for a wat-and-see policy. "The cumulative probability of strangulation in relation to the length of history has been calculated for inguinal and femoral hernias presenting to this hospital between 1987 and 1989. Of 476 hernias (439 inguinal, 37 femoral), there were 34 strangulations (22 inguinal, 12 femoral). After 3 months the cumulative probability of strangulation for inguinal hernias was 2.8 per cent, rising to 4.5 per cent after 2 years. For femoral hernias the cumulative probability of strangulation was 22 per cent at 3 months and 45 per cent at 21 months" (4).

Thus not only does the use of a mesh in hernia repairs create a risk of septic problems that can be difficult to manage but may also create risks of other very significant complications. If I were to have an inguinal hernia that required repair I would be extremely reluctant to have it repaired with a mesh. The same kind of case can be made against haemorrhoidectomies and varicose vein stripping and/or percutaneous treatments. Much of the bread-and-butter surgery in private practice may be unnecessary.

1. Poor solutions for poor surgery. Richard G Fiddian-Green (11 January 2004) Rapid response to: Andrew Kingsnorth. Treating inguinal hernias. BMJ 2004; 328: 59-60.
2. Are mesh repairs causing infertility and other urogenital disorders? Richard G Fiddian-Green bmj.com, 5 Dec 2004. Rapid response re: H D E Atkinson, S G Nicol, S Purkayastha, and S Paterson-Brown Surgical management of inguinal hernia: retrospective cohort study in southeastern Scotland, 1985-2001 BMJ 2004; 329: 1315-1316
3. Why are men being refused surgery for their hernias? By Victoria Lambert. Mail on line, Thursday, Jun 25 2009.
4. N. C. Gallegos, J. Dawson, M. Jarvis, M. Hobsley. Risk of strangulation in groin hernias British Journal of Surgery Volume 78 Issue 10, Pages 1171 - 1173

Competing interests None declared Source to article although their webpage changes wonder why?
www.bmj.com/content/338/bmj.b2321.extract/reply >>>
http://www.bmj.com/cgi/eletters/338/jun23_1/b2321#215740 >>>

Following is an abstract found in article dated 2010 from very reliable and trusted surgeons in the UK:
Midurethral tape placement is now established as the standard surgical treatment of USI. The United States Food and Drug Administration MAUDE (Manufacturer and user facility Device Experience) database has several reports related to meshes used in treating pelvic organ prolapse or SUI
(www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfMAUDE/search. CFM).

Furthermore, patient groups are developing their own websites and advocacy approaches, attesting to the importance of the issueAccordingly, we recommend that patients should be counseled that late complications occur in a higher proportion than previously recognized. As part of informed consent pre-operatively, patients should be made aware that TVT placement carries a risk potentially exceeding 4% of tape-related complications requiring further surgical intervention,which may not become apparent until nearly a decade after surgery.

HOW SECURE IS TVT SECUR?
www.tvt-messed-up-mesh.org.uk/pdfs/how-secur-tvt.pdf >>>

Minimally invasive synthetic suburethral slings: emerging complications
www.tvt-messed-up-mesh.org.uk/pdfs/minimally-invasive-synthetic.pdf >>>

2009 Annual Evidence Update Urinary Incontinence
www.tvt-messed-up-mesh.org.uk/pdfs/annual-evidence.pdf >>>

Insertion of biological slings for stress urinary incontinence in women
www.tvt-messed-up-mesh.org.uk/pdfs/Insertion-of-biological-slings.pdf >>>

Transobturator tape (TOT) Does it work?
www.tvt-messed-up-mesh.org.uk/pdfs/Transobturator-tape.pdf >>>

Long-term follow-up studies in pelvic floor dysfunction: the Holy Grail or a realistic aim?
Abstract: This is not a concept unique to pharmaceutical treatments, and we should safeguard our women against the prospect of Impharmageddon! by ensuring adequate evaluation of long-term outcomes of all pelvic floor surgery, most particularly those involving implanted materials.
www.tvt-messed-up-mesh.org.uk/pdfs/Long-Term-Outcomes-Pelvic-Floor-Dysfunction-Unknown.pdf >>>

NICE responds to enquiries regarding Technology Appraisal Guidance No 56: Tension-free vaginal tape (Gynecare TVT) for stress incontinence published in February 2003.
www.tvt-messed-up-mesh.org.uk/pdfs/NICE-responds-to-enquiries.pdf >>>

BMJ: Prospective multicentre randomised trial of tension-free vaginal tape and colposuspension as primary treatment for stress incontinence
www.tvt-messed-up-mesh.org.uk/pdfs/Prospective-multicentre-randomised-trial-of-tension-free-vaginal-tape.pdf >>>

Here is a quote seen in one article from a well respected medical expert
"If you are female, ask yourself whether or not you would want this procedure performed on yourself. If you are male, ask yourself whether or not you would want this procedure performed on your wife, sister, or mother."

Advisable to read frequently asked questions:
www.tvt-messed-up-mesh.org.uk/frequently-asked-questions.html >>>

More will be added shortly, thank you for your patience.

www.tvt-messed-up-mesh.org.uk/research.html >>>

For more information on our petition please visit here www.tvt-messed-up-mesh.org.uk/petitions.html