What are transvaginal mesh implants? Canadian campaigner Chrissy Brajcic dies from sepsis at 42
The implants are typically used to treat pelvic organ prolapse and incontinence in women but can have severe and damaging side effects.
[Update: This story has been updated to reflect the latest development.]
The National Institute for Health and Care Excellence (Nice) has called for a ban on transvaginal mesh implants given the damaging side effects they can have. According to the draft guidelines issued by the health watchdog, the implants should be banned from use in routine operations and only utilised for research purposes.
According to the document, which is expected to be released in December, the procedure when used to treat pelvic organ prolapse raises "serious but well-recognised safety concerns". It stated that "evidence of long-term efficacy is inadequate in quality and quantity".
"When complications occur, these can be serious and have life-changing consequences", it continued.
One of the major complications arises when the implants cut into the vagina, causing chronic pain, and difficulty while having sex, and in some cases even walking and doing every-day chores.
While Nice has recommended restriction of use for prolapse patients, it does not relate to mesh implants for incontinence.
Campaigners against the use of vaginal mesh welcomed the institute's draft guidance and expressed hope that it would push the National Health Service (NHS) to take implement a ban on its use across the UK.
"This is essentially a ban on the use of mesh to treat prolapse, as there is no research context in which it's likely to be used," Owen Smith, the Labour MP for Pontypridd told The Guardian. "It's also another move towards clinicians recognising the scale of the risk associated with mesh and an acknowledgement that mesh has been too widely seen as a quick fix for patients."
"The reports that mesh will be banned for treating organ prolapse in England are a step in the right direction but the government have to be clear about their position on this," shadow minister for public health and MP Sharon Hodgson opined.
"Ministers should take a lead and step in to take these products off the market while the guidance is being prepared. Labour is calling for a pause whilst a full inquiry uncovers the extent of the harm done by mesh implants so we can be sure that this never happens again," she added.
Most recently, vaginal mesh campaigner Chrissy Brajcic from Canada died on 29 November from sepsis after fighting a four-year-long health battle.
Reacting to the news of the 42-year-old's death, Australian pelvic mesh campaigner Caz Chisholm urged the Therapeutic Goods Administration to issue an umbrella ban on the medical product.
"Chrissy was sick for many years," Chisholm told TGA deputy secretary John Skerritt. "She fought hard. She was 42 years old and leaves behind two very young sons and a husband. It was a Johnson & Johnson stress incontinence mid-urethral sling that destroyed her life and finally took it forever."
In April, IBTimes UK reported that more than 800 women in the UK, who have undergone transvaginal mesh implants, were suing the NHS and the manufacturers.
What are transvaginal mesh implants?
Surgical mesh is a medical device that is used to provide extra support when repairing damaged tissue. Most surgical mesh devices are made from synthetic materials or animal tissue.
Transvaginal meshes or urogynaecological meshes are used to treat pelvic organ prolapse which occurs when a pelvic organ-such as your bladder rectum or uterus drops (prolapses) from its normal place in your lower belly and pushes against the walls of your vagina. This can happen when the muscles that hold your pelvic organs in place get weak or stretched from childbirth or surgery.
It is also used in cases of stress incontinence, a condition in which physical movement or activity — such as coughing, sneezing, running or heavy lifting — puts pressure (stress) on your bladder. This can lead to unintentional loss of urine. It is common among women after childbirth and at the menopause.
How do they work?
Usually made from synthetic polypropylene, transvaginal mesh implants are available in "sling", "tape", "ribbon", "mesh" and "hammock" form, based on the manufacturer's specifications. The mesh attempts to repair damaged or weakened tissue by providing a permanent support for the organ and prevent it from sagging.
Complications from transvaginal mesh implants
While results for use on incontinence patients proved more successful, women suffering from prolapse proved to suffer more complications. One of the most common serious issues rises when the mesh cuts through the vaginal wall.
Kate Langley, one of the patients who received an implant described the implants as "barbaric" and recalled making over 53 visits to the hospital to deal with the severe pain and nerve damage from the procedure. A doctor said the implant had cut through her vaginal wall "like a cheese-wire".
In many cases women were forced to quit their jobs and get additional care to manage living with the pain.
"I have chronic pelvic pain on a daily basis and I'm on 9 different medications when I have a pain attack," Margie Maguire, 41, told the Victoria Derbyshire programme. "These can last from 2 to 6 hours at a time and is like having a heart attack."
