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Halt in Use of Transvaginal Mesh

Medico Legal

Health boards have been instructed to completely stop all transvaginal mesh procedures until new protocols are developed and implemented, Health Secretary Jeane Freeman has told the Scottish Parliament.

The effective ban on the use of mesh for stress urinary incontinence and pelvic organ prolapse will remain in place until the Health Secretary is confident that a new ‘Restricted Use Protocol’ can be developed and implemented that would mean that the procedures could only be carried out only in the most limited circumstances, subject to rigorous process.

Other mesh procedures, such as transabdominal mesh, will be kept under active review and will also be subject to high vigilance procedures.

In a statement to Parliament, Ms Freeman said: “I have asked the Chief Medical Officer to instruct Health Boards to immediately halt the use of transvaginal mesh altogether in cases of both pelvic organ prolapsed and stress urinary incontinence, pending the implementation of a new Restricted Use Protocol that will ensure procedures are carried out only in the most exceptional circumstances and subject to a robust process of approval and fully informed consent.

The instruction to halt is, I believe, a proportionate measure whilst a rigorous, high vigilance ‘Restricted Use Protocol’ for any future practice is developed and put in place.

The lifting of this halt in use can only be considered once there is confidence that there is sufficient evidence that the protocol can only be triggered in only the most limited of circumstances – informed by any new evidence and the forthcoming NICE guidance which is expected in the spring of next year on the management of pelvic organ prolapsed and stress urinary incontinence.”

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