July 1, 2015

cochrane review of evidence on stress urinary incontinence surgery / vaginal mesh – effectiveness and side effects

Vaginal mesh surgery for stress urinary incontinence has been in the news over the last couple of years, with questions being asked about its safety, effectiveness and potential side effects. The procedure involves implanting a sling made of artificial mesh under the urethra to support the muscles of the bladder.

There have been a number of reports of women suffering pain and injury after surgery, and some suggestion that side-effects may be due to the sling which is made of non-absorbable plastic. This has led to court cases worldwide, with some already under way in the UK, the USA and Canada. In Scotland, the health minister called for hospitals to consider the suspension of mesh operations until more evidence is available. An independent review set up in Scotland in 2014 to review the safety of these operations will publish its findings later this year.

A new Cochrane systematic review of the evidence will contribute to the ongoing debate and aims to help women to make more informed choices about the treatment options available. This is one of a number of sources of evidence which will inform the findings of the Scottish independent review.

Authors of the Cohrane review came to the SMC to discuss things such as:

• What are these procedures designed to treat?
• Are there different types of operation available?
• What are the non-surgical alternatives?
• What kinds of side-effects have been reported?
• What does the evidence say – is this a safe and effective procedure?

Speakers:

Dr Abigail Ford, review lead author and specialist in obstetrics and gynaecology, Bradford Teaching Hospitals

Mr Joseph Ogah, review author and consultant gynaecologist and obstetrician, University Hospitals of Morecambe Bay NHS Foundation Trust

Prof. Cathryn Glazener, co-editor of the Cochrane Incontinence Group and Professor at the Health Services Research Unit, University of Aberdeen