Doctors say blanket restriction of surgical mesh not the way to go

Warning: This article contains descriptions of surgical procedures that may disturb some readers.

One gynaecologist says New Zealand women have been "butchered" by the use of surgical mesh.

But she told Newshub that Medsafe's blanket restrictions from January 2018 are 'ad hoc' and poorly thought out.

Hanifa Koya has performed more than 75 surgeries to repair damage caused by surgical mesh. She says New Zealand has a "mesh disaster" on its hands.

"It's the most butchered medical procedure performed on women," she said.

Ms Koya says the mesh disaster is worse than the Cartwright enquiry in the 1980s into unethical practices in the treatment of cervical cancer.

"Four of the meshes did not reach the door of the FDA, the others did not undergo any scrutiny, there were conflicts of interest, a lot surgeons were involved in making the meshes," she said.

ACC has paid out $13 million in mesh-injury claims to hundreds of women in the past decade.

"The commonest one would be erosion, where the mesh comes back through the vaginal skin," said Christchurch urologist Sharon English.

She says there are two main reasons the surgical mesh has been used.

"It's used for stress incontinence, so women with leakage with coughing and sneezing activity, jumping on the trampoline, and also for pelvic organ prolapse, so bulges coming down the vagina," said Dr English.

"There is no question that the vaginal meshes for vaginal prolapse should be removed," said Dr Koya.

But now its use is restricted, what options are there for patients?

Dr English says using a patient's own tissue for repair is one.

"Making a piece for under the bladder neck out of their tendon," said Dr English.

"The downside is it's a bigger operation, it's sorer, it's a cut across the tummy and it takes longer to recover from."

Australia banned surgical mesh implants for pelvic prolapse two weeks ago.

Dr English says New Zealand should follow Australia, and allow mesh to continue to be used for stress incontinence and hernias.

"The vaginal meshes are banned, because they are the ones that have caused the greatest problem," she said. "That's up to 20 percent in women."

Dr Koya would like to see a register for mesh products.

She says every surgical procedure carries risk and a device alone should not be blamed - surgical competence and informed consent are essential too.