Australian Doctor Australian Doctor 12 May 2017 | Page 11

News Review
Some of the 200 members of lobby group Australian Pelvic Mesh Support Group,
founded by Caz Chisholm (bottom left).
TRANSVAGINAL MESH:
BOON OR BANE?
The widespread
use of
transvaginal
mesh has
been touted as
another medical
device scandal.
Australian
Doctor
investigates.
BRETT EVANS AND CLARE PAIN
T
IN his previous working life, cross-
bench Senator Derryn Hinch was
a controversial tabloid journalist,
who delighted in the nickname ‘the
Human Headline’.
During his long media career the
Human Headline learnt a thing or
two about how to catch the atten-
tion of the Australian public.
Last year, he stood up in Parlia-
ment and attempted to link the
thalidomide scandal with a fresh
medical controversy.
“I am about to put a four-letter
word into the same category as
‘I AM ABOUT TO PUT A FOUR-LETTER WORD
INTO THE SAME CATEGORY AS THALIDOMIDE
... THAT FOUR-LETTER WORD IS MESH,
TRANSVAGINAL MESH.’
— Senator Derryn Hinch
thalidomide — a word that is not
crippling babies but has crippled
thousands of mothers both here and
overseas,” he told the Senate. “That
four-letter word is mesh, transvagi-
nal mesh.”
Simpler and less invasive
The use of transvaginal mesh in
urogynaecological surgery has
become a vexed issue. When device
manufacturers saw that surgeons
were using surgical mesh products
abdominally to treat stress urinary
incontinence and pelvic organ pro-
www.australiandoctor.com.au
lapse, they started to develop spe-
cific vaginal mesh products. They
were approved for use in urinary
stress incontinence by the US Food
and Drug Administration (FDA)
in 1996 and six years later for the
treatment of pelvic organ prolapse
(POP).
The devices were credited with
making the procedures simpler
and less invasive. Uptake, particu-
larly in the US, was significant,
but over the past decade, reports
of complications have increased,
with some women suffering ago-
nising chronic pain, nerve damage,
bleeding and infection, with mesh
erosion cutting through the vagi-
nal wall and sometimes perforat-
ing nearby organs.
In Australia, the issue has
surfaced in the public domain,
largely as a result of the lobby
group founded by Caz Chisholm,
a WA woman who had two mesh
implant procedures for stress
incontinence in 2014. The Austral-
ian Pelvic Mesh Support Group
now has over 200 members and is
active on social media. It was this
group that brought their stories to
the attention of Senator Hinch.
In February, this lobbying effort
resulted in the establishment of
a Senate inquiry to examine the
issue. It is likely that a stream of
medical experts will be called to
Canberra to provide their expert
views on this highly charged topic.
Warnings and complications
The FDA first issued an alert about
the devices and their potentially
serious complications in 2008. It
was another three years before the
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12 May 2017 | Australian Doctor |
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