The Australian Commission on Safety and Quality in Health Care (the Commission) organised a series of consumer consultation forums with the assistance of state health consumer councils in Brisbane, Melbourne, Perth and Sydney from January to March 2017. The intent was to provide consumers with the opportunity to provide information about their experience of transvaginal mesh treatment to inform the development of patient decision support resources.
Thirty-one women participated in the forums, either in person or by telephone. All but one of the women who participated in the forums had experienced complications following transvaginal mesh treatment, and the majority of participants had been treated for stress urinary incontinence.
Since this time, the Commission has embarked on the development of patient information resources, which have been informed by the forums. As part of this process a working group has been formed to guide development and two further meetings in Sydney and Perth were held with women who have had mesh implanted to comment on the draft resources. The resources will be finalised in conjunction with the working group and the women we have met during the consultation process
The common themes and issues raised by women who attended the forums are summarised below.
Some women who attended the forums thought that transvaginal mesh should be banned because of the serious complications it could cause. Others acknowledged that, as there are women who have benefited from treatment with mesh, informed consent, ensuring that surgeons have the right skills, better reporting of complications and better information on the number of women who have had transvaginal mesh procedures should be a priority.
The Commission will work with a number of women, representatives of the peak health consumer councils in New South Wales, Queensland, Victoria and Western Australia, and clinical experts from the Transvaginal Mesh Reference Group to develop information for women to assist with decisions on treatment options for stress urinary incontinence, pelvic organ prolapse and transvaginal mesh complications.
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists has information on use of mesh for treatment of pelvic organ prolapse available on its website. The College is currently reviewing its information on use of mesh for treatment of stress urinary incontinence.
The Urogynaecological Society of Australasia also has a range of information available for patients on pelvic organ prolapse and stress urinary incontinence and treatment options.
The Commission has developed Top Tips for Safe Health Care to help consumers, their families, carers and other support people get the most out of their health care. The booklet includes information on providing feedback to healthcare providers and organisations and making and resolving complaints.
The Therapeutic Goods Administration has information on its web site about mesh complications, reporting of complications and action it has taken in relation to mesh.
The Australian Senate Community Affairs References Committee is leading an inquiry into the number of women in Australia who have had transvaginal mesh implants and related matters. Submissions should be received by 31 May 2017. The reporting date is 30 November 2017.
There is more information on the Commission’s work on Transvaginal mesh here.