States, territories and private health services – transvaginal mesh

The use and removal of transvaginal mesh is of great importance to both public and private health services in Australia. Each state and territory is reviewing the provision of these services, and some have developed specific information resources and support services.  For example, dedicated telephone information and referral services and improved coordination and designation of services to promote a more integrated means for women to access services.

The Service Model Framework for transvaginal mesh complications and removal includes a summary of services in each state and territory, where available.

NSW

NSW Health provides information through its website at www.health.nsw.gov.au/patients/Pages/default.aspx

Information for patients - www.health.nsw.gov.au/sabs/Publications/patients-with-mesh-implant.pdf

Information for GPs - www.health.nsw.gov.au/sabs/Publications/gp-mesh-implants.pdf

NSW Health specialist services are provided at:
  Nepean Hospital Phone: 02 4734 1474 or 02 4734 2000
  Royal North Shore Hospital Phone: 02 9463 2377
  Royal Prince Alfred Hospital Phone: 02 9515 4526 or 0459 899 735
  St George Hospital Phone: 02 9113 2272 or 02 9113 1588
  Westmead Hospital Phone: 02 8890 7668

Arrangements are in place for referrals from patients outside of these Local Health Districts to the specialist clinics. Patients from rural and remote regions will be able to be seen at any of these specialist services. Services available at the hospitals listed above include: urogynaecology, ultrasound, pain services, pelvic floor physiotherapists, psychology, urology, and colorectal.

There is also a NSW Safety Notice and recommendations for NSW Health facilities - Transvaginal mesh implants for pelvic organ prolapse. www.health.nsw.gov.au/sabs/Documents/2017-sn-015.pdf

VIC

Information for GPs can be found at:
www2.health.vic.gov.au/hospitals-and-health-services/safer-care-victoria/safer-care-publications/transvaginal-mesh-complications

Information and links to important information such as credentialing and freedom of information resources on the website: www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/Transvaginal-mesh

Specialist multidisciplinary services are provided at:

  • Royal Women’s Hospital Phone: 03 8345 3143
  • Mercy Hospital for Women Phone: 03 8458 4500
  • Monash Health Phone: 03 9928 8588
  • Western Health Phone: 0481 908 118

Royal Women's Hospital, phone (03) 8345 3143: urogynaecology is the lead discipline, with services such as plastic surgery, urology and colorectal surgery also involved, depending on patient needs. Patients can also access pain physicians and physiotherapists at the Royal Women’s Hospital. 

Mercy Hospital for Women, phone (03) 8458 4500: a multi-disciplinary team provides services for affected women. Services include urogynaecology, urology, colorectal surgery, pain management and community linkage with psychiatric services.

Monash Health, phone (03) 9928 8588: the Pelvic Floor Unit leads care, in conjunction with physiotherapy, pain management, and where indicated, colorectal, urology and plastic surgery. Other specialised services at the hospital include psychology, a sexual and relationship difficulty clinic, and a continence nursing service.

Western Health, phone 0481 908 118: services include urogynaecology, urology, colorectal surgery, pain management and community linkage with psychiatric services. The lead discipline is urogynaecology with a multidisciplinary clinic involving urology, pelvic floor physiotherapy and continence nursing.

QLD

Queensland Health have established the Queensland Pelvic Mesh Service, a holistic service with a team of specialists dedicated to treating, supporting and caring for women who have experienced complications from pelvic mesh.

The Queensland Pelvic Mesh Service, located at Varsity Lakes Day Hospital on the Gold Coast accepts referrals from general practitioners for women experiencing complications from pelvic mesh (also known as transvaginal mesh). The statewide interdisciplinary service has been co-designed by consumers and clinicians to ensure a patient-centric model of care is provided to women. Travel and accommodation subsidies are available for eligible women who need to travel more than 50kms from their home to attend the Queensland Pelvic Mesh Service.

The Queensland Pelvic Mesh Service was developed to assist women who have experienced pelvic mesh-related complications, including women with chronic pelvic pain, mesh exposure, infection, bleeding, dyspareunia, incontinence, bladder and bowel perforation, difficulty sitting and walking.

A team of medical, nursing and allied health specialists - including physiotherapy, psychology and social work - offer comprehensive treatment and assessment within a mutually respectful and supportive environment. Expertise in surgery, continence care, chronic pain management and counselling is offered as required, to assist women in their activities of daily life and in their recovery.

The Service partners with each woman to develop a treatment and recovery plan that best suits individual needs. Surgery may be considered a part of the woman’s treatment plan, based on best practice and available evidence. Treatment and care options are transparently discussed between the care provider and the woman.

Patients attending the service are assessed and treated by members of the interdisciplinary team. Telehealth services for follow-up care are available for women unable to return to the Queensland Pelvic Mesh Service.

When treatment is completed, the interdisciplinary team will transition the patient back to their local community where ongoing management and support will be coordinated through their primary care provider.

Queensland Pelvic Mesh Service referral forms and Clinical Prioritisation Criteria are available for general practitioners at www.health.qld.gov.au/clinical-practice/referrals/statewide-specialist-services/queensland-pelvic-mesh-service

Queensland Health also has a range of resources for women and consumers at www.qld.gov.au/health/services/specialists/pelvic-mesh-service/patient-resources

Queensland Pelvic Mesh Service contact details:
Phone: (07) 5619 0772
Email: QPMSReferralsGCHHS@health.qld.gov.au
Website: www.qld.gov.au/health/services/specialists/pelvic-mesh-service
 

SA

SA Health has established a Consumer Support telephone line on 1800 66 MESH. The line operates 0800-1600 Monday to Friday, excluding public holidays.

Consumer and GP Information related to pelvic mesh is available at: www.sahealth.sa.gov.au/pelvicmesh

SA Health has established a Pelvic Mesh Clinic at the Royal Adelaide Hospital to provide comprehensive multi-disciplinary health care for women experiencing major complications related to pelvic mesh implants that will:
- provide care in accordance with nationally agreed-upon standards and guidelines
- enhance clinical knowledge resulting from the collaboration of various clinical specialists
- provide access to telehealth assessments
- ensure patient involvement in the decision-making process
- improve the quality of life, mental health and overall well-being of affected women.

SA Health provides a statewide urogynaecology/gynaecology referral service, where care is provided by specialist gynaecologists with ready access to urology, plastics and colorectal services, specialised pelvic floor nurse physio; continence nurses and pain management services at the following sites:

  • Flinders Medical Centre                        Phone (08) 8204 5511
  • Lyell McEwin Hospital                           Phone (08) 8182 9000
  • Women’s and Children’s Hospital         Phone (08) 8161 7000
  • The Queen Elizabeth Hospital              Phone (08) 8222 6000
  • Royal Adelaide Hospital                        Phone (08) 7074 0000

In addition, SA Health provides less complex urogynaecology/gynaecology referral services at Modbury Hospital where there is access to physiotherapists; continence nurses and pain management services.

In country South Australia:

  • Mt Gambier Hospital provides a urogynaecology/gynaecology referral service, for some complex cases led by specialist gynaecologists with access to physio; continence nurses and pain management services
  • Port Pirie Hospital, Murray Bridge Hospital; Berri Hospital; Port Augusta Hospital; Mount Barker Hospital; and Narracoorte Hospital all offer low risk gynaecology services provided by visiting specialist gynaecologists. These hospitals refer complex cases to larger services.

WA

WA Health provides a Pelvic Mesh phone line through 1800 962 202

Further information is available at: www.healthywa.wa.gov.au/Articles/N_R/Pelvic-mesh

In Western Australia, the King Edward Memorial Hospital (KEMH) provides a comprehensive multidisciplinary team based approach for gynaecological pelvic mesh complications. Women with gynaecological mesh complications are offered access to the multidisciplinary team depending on their needs. The mesh complications clinic is staffed by: urogynaecologists, urologists, pain specialists, ultrasound specialists, clinical psychologists, women’s health and continence physiotherapists, specialist nurse, social workers, occupational therapists. Surgery, including mesh removal, is available. Surgery is offered on an individual basis as part of the multidisciplinary treatment plan.

TAS

Tasmania has a small number of public and private hospitals providing mesh implantation for SUI and even fewer for POP and for removal of mesh. Most patients access services through GP referral into a gynaecology clinic at one of the following hospitals

Royal Hobart Hospital                          Phone: 03 6166 8308
North West Regional Hospital              Phone: 03 6493 6000
Launceston General Hospital               Phone: 03 6777 6777
Tasmanian Health Services support     Email: THS.alertsandrecalls@ths.tas.gov.au

Mesh implantation for SUI is available at all three hospitals. Mesh implantation for POP (with appropriate credentialing and ethics approval for a formal research trial) and removal of mesh is available at Royal Hobart Hospital and Launceston General Hospital.

The Royal Hobart Hospital has a full urogynaecology service, including services for urodynamics, advanced surgery (vaginal + laparoscopic mesh and native tissue), management of mesh exposure, pelvic physiotherapy, urogynaecology nurse and medical consultant. There are no sub-specialist urogynaecologists.

The Launceston General Hospital has a full specialist obstetrics and gynaecology service that offers both mesh insertion and removal. Complex cases are referred to Melbourne.

ACT

The ACT has a multidisciplinary team based service located at the Canberra Hospital for ACT women experiencing complications that may be related to pelvic mesh. The team includes dedicated medical, nursing, pelvic physiotherapy and pain psychology staff.

Contact details are:

Phone: 02 2512474

meshreview@act.gov.au

https://health.act.gov.au/pelvicmesh

Patients requiring further investigations for potential mesh removal are referred by this service to the Urogynaecology Service at Westmead Hospital, Sydney.

NSW

NSW Health provides information through its website at www.health.nsw.gov.au/patients/Pages/default.aspx

Information for patients - www.health.nsw.gov.au/sabs/Publications/patients-with-mesh-implant.pdf

Information for GPs - www.health.nsw.gov.au/sabs/Publications/gp-mesh-implants.pdf

NSW Health specialist services are provided at:
  Nepean Hospital Phone: 02 4734 1474 or 02 4734 2000
  Royal North Shore Hospital Phone: 02 9463 2377
  Royal Prince Alfred Hospital Phone: 02 9515 4526 or 0459 899 735
  St George Hospital Phone: 02 9113 2272 or 02 9113 1588
  Westmead Hospital Phone: 02 8890 7668

Arrangements are in place for referrals from patients outside of these Local Health Districts to the specialist clinics. Patients from rural and remote regions will be able to be seen at any of these specialist services. Services available at the hospitals listed above include: urogynaecology, ultrasound, pain services, pelvic floor physiotherapists, psychology, urology, and colorectal.

There is also a NSW Safety Notice and recommendations for NSW Health facilities - Transvaginal mesh implants for pelvic organ prolapse. www.health.nsw.gov.au/sabs/Documents/2017-sn-015.pdf

VIC

Information for GPs can be found at:
www2.health.vic.gov.au/hospitals-and-health-services/safer-care-victoria/safer-care-publications/transvaginal-mesh-complications

Information and links to important information such as credentialing and freedom of information resources on the website: www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/Transvaginal-mesh

Specialist multidisciplinary services are provided at:

  • Royal Women’s Hospital Phone: 03 8345 3143
  • Mercy Hospital for Women Phone: 03 8458 4500
  • Monash Health Phone: 03 9928 8588
  • Western Health Phone: 0481 908 118

Royal Women's Hospital, phone (03) 8345 3143: urogynaecology is the lead discipline, with services such as plastic surgery, urology and colorectal surgery also involved, depending on patient needs. Patients can also access pain physicians and physiotherapists at the Royal Women’s Hospital. 

Mercy Hospital for Women, phone (03) 8458 4500: a multi-disciplinary team provides services for affected women. Services include urogynaecology, urology, colorectal surgery, pain management and community linkage with psychiatric services.

Monash Health, phone (03) 9928 8588: the Pelvic Floor Unit leads care, in conjunction with physiotherapy, pain management, and where indicated, colorectal, urology and plastic surgery. Other specialised services at the hospital include psychology, a sexual and relationship difficulty clinic, and a continence nursing service.

Western Health, phone 0481 908 118: services include urogynaecology, urology, colorectal surgery, pain management and community linkage with psychiatric services. The lead discipline is urogynaecology with a multidisciplinary clinic involving urology, pelvic floor physiotherapy and continence nursing.

QLD

Queensland Health have established the Queensland Pelvic Mesh Service, a holistic service with a team of specialists dedicated to treating, supporting and caring for women who have experienced complications from pelvic mesh.

The Queensland Pelvic Mesh Service, located at Varsity Lakes Day Hospital on the Gold Coast accepts referrals from general practitioners for women experiencing complications from pelvic mesh (also known as transvaginal mesh). The statewide interdisciplinary service has been co-designed by consumers and clinicians to ensure a patient-centric model of care is provided to women. Travel and accommodation subsidies are available for eligible women who need to travel more than 50kms from their home to attend the Queensland Pelvic Mesh Service.

The Queensland Pelvic Mesh Service was developed to assist women who have experienced pelvic mesh-related complications, including women with chronic pelvic pain, mesh exposure, infection, bleeding, dyspareunia, incontinence, bladder and bowel perforation, difficulty sitting and walking.

A team of medical, nursing and allied health specialists - including physiotherapy, psychology and social work - offer comprehensive treatment and assessment within a mutually respectful and supportive environment. Expertise in surgery, continence care, chronic pain management and counselling is offered as required, to assist women in their activities of daily life and in their recovery.

The Service partners with each woman to develop a treatment and recovery plan that best suits individual needs. Surgery may be considered a part of the woman’s treatment plan, based on best practice and available evidence. Treatment and care options are transparently discussed between the care provider and the woman.

Patients attending the service are assessed and treated by members of the interdisciplinary team. Telehealth services for follow-up care are available for women unable to return to the Queensland Pelvic Mesh Service.

When treatment is completed, the interdisciplinary team will transition the patient back to their local community where ongoing management and support will be coordinated through their primary care provider.

Queensland Pelvic Mesh Service referral forms and Clinical Prioritisation Criteria are available for general practitioners at www.health.qld.gov.au/clinical-practice/referrals/statewide-specialist-services/queensland-pelvic-mesh-service

Queensland Health also has a range of resources for women and consumers at www.qld.gov.au/health/services/specialists/pelvic-mesh-service/patient-resources

Queensland Pelvic Mesh Service contact details:
Phone: (07) 5619 0772
Email: QPMSReferralsGCHHS@health.qld.gov.au
Website: www.qld.gov.au/health/services/specialists/pelvic-mesh-service
 

SA

SA Health has established a Consumer Support telephone line on 1800 66 MESH. The line operates 0800-1600 Monday to Friday, excluding public holidays.

Consumer and GP Information related to pelvic mesh is available at: www.sahealth.sa.gov.au/pelvicmesh

SA Health has established a Pelvic Mesh Clinic at the Royal Adelaide Hospital to provide comprehensive multi-disciplinary health care for women experiencing major complications related to pelvic mesh implants that will:
- provide care in accordance with nationally agreed-upon standards and guidelines
- enhance clinical knowledge resulting from the collaboration of various clinical specialists
- provide access to telehealth assessments
- ensure patient involvement in the decision-making process
- improve the quality of life, mental health and overall well-being of affected women.

SA Health provides a statewide urogynaecology/gynaecology referral service, where care is provided by specialist gynaecologists with ready access to urology, plastics and colorectal services, specialised pelvic floor nurse physio; continence nurses and pain management services at the following sites:

  • Flinders Medical Centre                        Phone (08) 8204 5511
  • Lyell McEwin Hospital                           Phone (08) 8182 9000
  • Women’s and Children’s Hospital         Phone (08) 8161 7000
  • The Queen Elizabeth Hospital              Phone (08) 8222 6000
  • Royal Adelaide Hospital                        Phone (08) 7074 0000

In addition, SA Health provides less complex urogynaecology/gynaecology referral services at Modbury Hospital where there is access to physiotherapists; continence nurses and pain management services.

In country South Australia:

  • Mt Gambier Hospital provides a urogynaecology/gynaecology referral service, for some complex cases led by specialist gynaecologists with access to physio; continence nurses and pain management services
  • Port Pirie Hospital, Murray Bridge Hospital; Berri Hospital; Port Augusta Hospital; Mount Barker Hospital; and Narracoorte Hospital all offer low risk gynaecology services provided by visiting specialist gynaecologists. These hospitals refer complex cases to larger services.

WA

WA Health provides a Pelvic Mesh phone line through 1800 962 202

Further information is available at: www.healthywa.wa.gov.au/Articles/N_R/Pelvic-mesh

In Western Australia, the King Edward Memorial Hospital (KEMH) provides a comprehensive multidisciplinary team based approach for gynaecological pelvic mesh complications. Women with gynaecological mesh complications are offered access to the multidisciplinary team depending on their needs. The mesh complications clinic is staffed by: urogynaecologists, urologists, pain specialists, ultrasound specialists, clinical psychologists, women’s health and continence physiotherapists, specialist nurse, social workers, occupational therapists. Surgery, including mesh removal, is available. Surgery is offered on an individual basis as part of the multidisciplinary treatment plan.

TAS

Tasmania has a small number of public and private hospitals providing mesh implantation for SUI and even fewer for POP and for removal of mesh. Most patients access services through GP referral into a gynaecology clinic at one of the following hospitals

Royal Hobart Hospital                          Phone: 03 6166 8308
North West Regional Hospital              Phone: 03 6493 6000
Launceston General Hospital               Phone: 03 6777 6777
Tasmanian Health Services support     Email: THS.alertsandrecalls@ths.tas.gov.au

Mesh implantation for SUI is available at all three hospitals. Mesh implantation for POP (with appropriate credentialing and ethics approval for a formal research trial) and removal of mesh is available at Royal Hobart Hospital and Launceston General Hospital.

The Royal Hobart Hospital has a full urogynaecology service, including services for urodynamics, advanced surgery (vaginal + laparoscopic mesh and native tissue), management of mesh exposure, pelvic physiotherapy, urogynaecology nurse and medical consultant. There are no sub-specialist urogynaecologists.

The Launceston General Hospital has a full specialist obstetrics and gynaecology service that offers both mesh insertion and removal. Complex cases are referred to Melbourne.

ACT

The ACT has a multidisciplinary team based service located at the Canberra Hospital for ACT women experiencing complications that may be related to pelvic mesh. The team includes dedicated medical, nursing, pelvic physiotherapy and pain psychology staff.

Contact details are:

Phone: 02 2512474

meshreview@act.gov.au

https://health.act.gov.au/pelvicmesh

Patients requiring further investigations for potential mesh removal are referred by this service to the Urogynaecology Service at Westmead Hospital, Sydney.