Question to the Department of Health and Social Care:

To ask Her Majesty's Government what action they are taking to prevent mesh from being offered routinely to patients as a first intervention.

The National Institute for Health and Care Excellence (NICE) has published eight pieces of interventional procedures guidance that make a number of different recommendations about the safety and efficacy of various procedures using mesh to treat stress urinary incontinence or pelvic organ prolapse. They also emphasise the importance of informed consent and data collection, along with the requirement to report adverse events and the need for special training to undertake these procedures.

The most recent update was an update of its Transvaginal mesh repair of anterior or posterior vaginal wall prolapse interventional procedures guidance published on 15 December 2017. NICE recommends that this procedure should only be used in the context of research. The updated NICE recommendation does not constitute a “ban”, but specifies that research should include details of patient selection, long-term outcomes including complications, type of mesh used and method of fixation, and quality of life. A copy of the guidance is attached.

Additionally, NICE is extending its clinical guideline on the management of urinary incontinence in women to also include pelvic organ prolapse. The final guideline is expected to be published in 2019.