What is vaginal mesh and what has been said about the medical scandal?

While the vaginal mesh scandal flew under the radar for an astonishing amount of time, the media and vaginal mesh victims have finally brought this important issue to the forefront.

What is vaginal mesh?

Vaginal mesh are implants used by medical professionals to treat stress incontinence and pelvic organ prolapse, both of which can occur after childbirth. They're inserted into the vagina from the abdomen, and used as an alternative for more invasive surgery.

“Mesh” is a plastic netlike implant that comes in a number of forms including - “sling”, “tape”, “ribbon”, “mesh” and “hammock”. There are multiple brands and manufacturers of it. Johnson & Johnson are the most well known.

Mesh is used medically to treat and fix many medical complaints - but we’re specifically talking about urogynaecological mesh here, or transvaginal mesh, as it is technically called, which has been in use since the late 90s as a treatment for the above medical issues. Often, vaginal mesh istouted as the 'better option' by the medical industry. However, it is normally a cheap and quick 'fix'.

But there's a darker side to the mesh story, with many women left in excruciating pain, suffering long-term health problems as a result of being fitted with them. Many women experience cutting, scarring, pain and discomfort, and pain during intercourse.

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In some tragic cases, women's experiences with vaginal mesh have even been fatal.

The vaginal mesh scandal, according to reports, claimed its first life in 2017. Canadian woman Chrissy Brajcic, who actively campaigned against the implants, died from sepsis from her own implant, after suffering problems for four years. The 42-year-old mum-of-two had set up a campaign to raise awareness of implant issues, after experiencing them herself after giving birth in 2013.

Despite having the mesh removed due to nerve damage, Chrissy experienced continual urinary tract infections and was readmitted to hospital this October, where she died weeks later.

Baroness Cumberlege's mesh review was released today

A damning report published yesterday has stated that vaginal mesh concerns from women have been 'dismissed' by the medical profession for years. It states that too often, the worries over vaginal mesh - as well as the ill effects over other procedures and medicines - has been dismissed as 'women's problems'.

Review chair Baroness Julia Cumberlege said she was shocked by the "sheer scale" of suffering from women, and urged that the health care system must apologise to women for being so dismissive.

She said, "I have conducted many reviews and inquiries over the years, but I have never encountered anything like this.Much of this suffering was entirely avoidable, caused and compounded by failings in the health system itself."

She however praised campaigners like Kath Sansom (above) who have been working for years to raise awareness of the issues highlighted in the report.

The review also shared the missed opportunities, when something could or should have been done to prevent harm to women.

Vaginal mesh problems: the longterm impact

Pain and cutting are not the only terrible side-effects of the implants. Some women report that the mesh implants protrude so much that they've even damaged their partner during sex (as well as their own anatomy). Others have revealed that they are now unable to work and, for some sufferers, even walking has become a struggle. Dr Sohier Elneil, who has worked with various mesh victims, told the BBC about the affected patients she has seen. She said, "They become so incapacitated that many of them are either walking by crutches or sitting in wheelchairs and perhaps more dramatically so, they become unable to look after their families."

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"Unfortunately, they're incredibly difficult to remove because tissue grows around the vaginal mesh, meaning that although women are told they're not permanent, they're often almost impossible to get rid of."

Stella Channing, one woman campaigning against vaginal mesh, who was fitted with an implant herself seven years ago in Australia, said of her experiences, "You spend your day thinking that the best way to get through the day would be to drug yourself up,"

"You take pain killers and then take sleeping tablets, so that you can try and escape the raw burning pain and the ongoing nerve pain that makes you writhe in agony."

For Stella, the mesh implants are a life sentence - and she can't see how her issues will ever be resolved. "For themeshinjured, it is a life of non-stop chronic, debilitating pain, that does not go, does not heal and most likely will not bring imminent death, just a lingering of life that is so hard to bear."

Side effects of vaginal mesh include, but are not limited to:

1. Pain on walking

2. Urinary urgency

3. Pain on sitting

4. Severe fatigue

5. Chronic fatigue

6. IBS symptoms

7. Chronic or recurring leg pain

8. Pain during sex

9. Incontinence

10. Anxiety

How many women have suffered due to surgical mesh?

The Washington Post reports that as of January 2019, 3 - 4 million women have been fitted with transvaginal mesh worldwide, and of that number, around 150,000 - 200,000 have suffered complications.

In January 2017, UK hospital figures obtained by Sky News suggested that almost 10 per cent of women suffer complications following their treatment. At the time, urogynaecologist Sohier Elneil told Sky News, "It's a huge problem. I think it's bigger than Thalidomide, because the numbers of those affected are much more. And if we look at the problem globally then it's worse than the metal-on-metal hips and the PIP scandal as well."

Why is vaginal mesh proving so harmful?

Kath Samson, founder of Sling The Mesh, a group campaigning to ban vaginal mesh, has argued that the problem is largely down to a 'one for all' mentality.

"For incontinencemeshslings in the UK the surgeon societies are saying it is an effective treatment for 'appropriately selected women' - but we say, who is an appropriately selected woman?" Kath told us. "We have women of all ages, sizes, races, some smoke some do not - there is no way of telling who will suffer. It truly is Russian roulette. How can you pick who is a good candidate?"

Kath had the operation herself in 2015 to treat minor stress incontinence, and was told the procedure was "a very simple and quick fix; perfect for busy working mums to be back at their desks in a week, with the risks very much downplayed". However, she later reported feeling an intense burning and pain, alongside bruising. It was this painful experience that inspired her to start the campaign.

The backlash against vaginal mesh

Back in April 2017, BBC's Victoria Derbyshire reported that over 800 women were suing the NHSover the implants, following claims that the procedure has caused them irreparable damage, and horrendous side effects such as cutting, debilitating bleeding and pain, and the inability to have intercourse.

The women suing are levelling their criticism in particular at huge company Johnson and Johnson, who are one of the largest producers of the implants.

And cases aren't just mounting in the UK. Huge court cases have been taking place across the world. In Australia, the Australian Pelvic Mesh Support Groupcaught the media's attention across the globe after they released a series of statements from women, expressing their outrage over how they have been treated by doctors regarding their complaints.

In March last year, an Australian court ordered vaginal mesh implant manufacturers, Johnson& Johnson to pay three women $2.6 million collectively in compensation, on the grounds that the company had misled patients and surgeons about the risks of the implants.

The landmark case has paved the way for compensation for victims of these dangerous vaginal mesh implants, as 1,350 other women in Australia are also launching legal cases against the company. Johnson& Johnson are also facing similar law suits in Europe, Canada and the US for negligence, as they put these implants on the market before thorough testing.

What's being done about vaginal mesh?

Recent legal action shows promising progress in compensating those who have suffered with the implants.

And while it may be a slow process, Sling The Mesh are making real progress in changing the law around vaginal mesh implants.

In 2018, NICE (National Institute for Care and Health Excellence), urged that vaginal mesh should only be used as a last resort in cases of urinary incontinence and pelvic organ prolapse. And other developments are underway - see the latest updates here. However, there are still hurdles to move past. Recently, the Victoria Derbyshire show reported that dozens of women who were told they were having the mesh fully removed have found that some material has been left inside them.

For Kath, steps to prevent mesh casualties need to be put into motion as early as possible.

"I think girls need to be educated from a young age about doing pelvic floor exercises, maybe in secondary school PE classes even - withouttheboys of course who would laugh. Butthey need to understand how important it is to look aftertheir core pelvic muscles.Alsothere needs to be better education around delivery.

"There is a lot of talk at the moment about forceps delivery causing problems of SUI and prolapse later. There needs to be better care after a woman has given birth all round. 50 years ago for example most mums gave birth in their local nursing home and stayed resting for 2 weeks., Now women are up and out and back home within a couple of days which puts unnecessary strain on their pelvic floors.

"Surgeons must offer women natural tissue repairs instead of pushing mesh. And women need to know the terrible life changing risks and not be so quick to go under the knife for a mesh implant."