SOME of thefirst pelvic mesh devices in the world were implanted in women in Western in the late 1980s.
Since that time an unknown number of n women have received mesh devices to treat incontinence and prolapse complications after childbirth.
It is fair to say that some incontinence mesh devices have been the subject of randomised controlled trials showing low complication rates, when implanted by skilled and experienced surgeons. It is also fair to say that complication rates for prolapse devices, with little or no evidence of safety and efficacy, are high and the complications are permanent and disabling for many women.
Which begs the question why it has taken so long for to reach this point –where a Senate inquiry has recommended pelvic mesh devices through the vagina should only be used as a last resort, where a landmark legal class action has heard evidence of devastating injuries to hundreds of women, and where the largest mesh manufacturer has withdrawn devices from the n market after regulators finally declared all pelvic mesh devices high risk?
The answer seems to lie with our health system, where treatments, devices and procedures are cleared for use and doctors are free to use and adopt them, but where the mechanisms for stopping such use are slow, limited and lack transparency.
In March more than 30 of the world’s leading back pain specialists issued an extraordinary statement to say that lower back pain is being mistreated on an enormous scale, with hundreds of thousands of n back pain sufferers being given harmful or useless treatments.
It costs n taxpayers $4.8 billion a year to fund those treatments, prompting a Sydney University expert who co-authored the study to say that we have a healthindustry that’s “essentially allowed to do as it pleases in terms of marketing unproved products”.
That is what happened with pelvic mesh devices, with tragic results for women.
nib chief executive Mark Fitzgibbon is right when he says doctors “howl down” anyone who dares to questiontheir right to diagnose and treat patients as they see fit, even with treatments that lack evidence of safety or efficacy. The pelvic mesh issue has shown it’s about time wechallengedsome of the reasons behind those howls.