Revised: 7 August 2018
Medical Devices
Surgical Mesh Implants - Information for Healthcare Professionals
The relevant professional colleges provide general guidance and specific guidelines on their websites, links to some of which are provided further down this page.
Guidance from Medsafe
On 11 May 2018, the Director-General of Health wrote to all Chief Executive
Officers of District Health Boards and private surgical hospitals to remind
them that surgical mesh remains an important clinical issue, to update them
on recent developments and to describe actions to be taken in response to
the information provided in the letter.
Medsafe advice to professional colleges (PDF 754 KB, 2 pages)
On 11 December 2017 Medsafe provided the professional colleges with information
about our regulatory request for safety information. Surgeons planning surgery
using urogynaecological mesh implants should contact the company supplying
the specific implant required to determine availability.
Medsafe advice to professional colleges (PDF 2 MB, 4 pages)
In September 2015, Medsafe wrote to all Chief Executive Officers of District Health Boards and private surgical hospitals to advise them of the latest information available at that time about the use of surgical mesh, particularly for urogynaecological applications. A copy of this letter was also sent to the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and the Urological Society of Australia and New Zealand (USANZ).
The key issues were that clinicians should:
- Consider research material and include it into their assessment and decision-making process with respect to examining and determining treatment options for patients under their care
- Communicate the treatment options with patients and discuss with them the evidence supporting the risks and benefits of the treatment option being proposed, in clear and simple terms to allow the patient to make an informed decision on their treatment.
A copy of this letter is available for download below:
Medsafe
advice to clinicians (PDF 1.4MB, 2 pages)
While some of the links provided in this letter are no longer available or have been updated, the general advice provided remains current.
Information from College of Obstetricians and Gynaecologists
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists
(RANZCOG) trains and accredits obstetricians and gynaecologists in Australia
and New Zealand. It has published information on its website regarding the
use of urogynaecological surgical mesh implants.
Pelvic Mesh Information
https://www.ranzcog.edu.au/Mesh-Resources
Response to the Health Committee of New Zealand House of Representatives
Report on Surgical Mesh
https://www.ranzcog.edu.au/news/Response-to-the-Health-Committee-of-New-Zealand-Ho
Use of mesh for the surgical treatment of vaginal prolapse and urinary
incontinence
https://www.ranzcog.edu.au/news/Use-of-mesh-for-the-surgical-treatment-of-vaginal
Polypropylene vaginal mesh implants for vaginal prolapse
https://www.ranzcog.edu.au/RANZCOG_SITE/media/RANZCOG-MEDIA/Women%27s%20Health/Statement%20and%20guidelines/Clinical-Obstetrics/Polypropylene-vaginal-mesh-implants-for-vaginal-prolapse-(C-Gyn-20)-Review-November-2016.pdf?ext=.pdf
Position statement on midurethral slings
https://www.ranzcog.edu.au/RANZCOG_SITE/media/RANZCOG-MEDIA/Women%27s%20Health/Statement%20and%20guidelines/Clinical%20-%20Gynaecology/Position-statement-on-midurethral-slings-(C-Gyn-32)_1.pdf?ext=.pdf
Mid-urethral tapes for genuine stress incontinence
https://www.ranzcog.edu.au/news/Mid-urethral-tapes-for-genuine-stress-incontinence
The Royal College of Obstetricians and Gynaecologists (RCOG) trains and accredits in the UK. RCOG has published the following regarding the use of vaginal tape and mesh implants:
Mesh resources to assist decision making
https://www.rcog.org.uk/en/guidelines-research-services/patient-safety/mesh/
RCOG and BSUG response to NHS England report
https://www.rcog.org.uk/en/news/rcog-and-bsug-response-to-nhs-england-mesh-report/
Information from other Medical Device Regulators
Several medical device regulators have published information about urogynaecological
surgical mesh implants on their websites. The regulators conclude that the
risks of complications are minimised when the product is used by surgeons
who have had suitable training. Below are links to this information.
Australian Therapeutic Goods Administration (TGA)
TGA actions after review into urogynaecological surgical mesh implants https://www.tga.gov.au/alert/tga-actions-after-review-urogynaecological-surgical-mesh-implants
Results of review into urogynaecological mesh implants
https://www.tga.gov.au/behind-news/results-review-urogynaecological-surgical-mesh-implants
US Food and Drug Administration (FDA)
Urogynaecological surgical mesh implants https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/UroGynSurgicalMesh/default.htm
Update on the Safety and Effectiveness of transvaginal placement for pelvic organ prolapse (PDF, 244kb) https://www.fda.gov/downloads/MedicalDevices/Safety/AlertsandNotices/UCM262760.pdf
UK Medicines and Healthcare Products Regulatory Agency (MHRA)
Final report: Use, safety and efficacy of transvaginal mesh implants in the treatment of stress urinary incontinence and pelvic organ prolapse in women (The final report from the Scottish independent review of the use, safety and efficacy of transvaginal mesh implants) https://www.gov.uk/government/publications/final-report-use-safety-and-efficacy-of-transvaginal-mesh-implants-in-the-treatment-of-stress-urinary-incontinence-and-pelvic-organ-prolapse-in-women
MHRA response to the final report of the Mesh Oversight Group https://www.gov.uk/government/news/mhra-response-to-the-final-report-of-the-mesh-oversight-group
Other Published Information on surgical mesh
Pause on the use of vaginally inserted surgical mesh for stress urinary incontinence https://www.gov.uk/government/news/pause-on-the-use-of-vaginally-inserted-surgical-mesh-for-stress-urinary-incontinence
Vaginal mesh for pelvic organ prolapse (NHS)
http://www.nhs.uk/conditions/Prolapse-of-the-uterus/Pages/Introduction.aspx
UK NICE guidance on use of mesh to repair uterine prolapse https://www.nice.org.uk/guidance/ipg577/ifp/chapter/What-has-NICE-said
PROSPECT study clinical trial results
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31596-3/fulltext